title: Developing a Deep Brain Stimulation Neuromodulation Network for Parkinson Disease, Essential Tremor, and Dystonia: Report of a Quality Improvement Project.
abstract: OBJECTIVE
  To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia.
  
  
  METHODS
  We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes.
  
  
  RESULTS
  The result of this quality improvement process was the development of a neuromodulation network. The key aspect of this program is rigorous patient assessment of both motor and non-motor outcomes tracked longitudinally using a REDCap database. We describe how this information is used to identify problems and to initiate Plan-Do-Study-Act cycles to address them. Preliminary outcomes data is presented for the cohort of PD and ET patients who have received surgery since the creation of the neuromodulation network.
  
  
  CONCLUSIONS
  Careful outcomes tracking is essential to ensure quality in a complex therapeutic endeavor like DBS surgery for movement disorders. The REDCap database system is well suited to store outcomes data for the purpose of ongoing quality assurance monitoring.
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Richard B
authors.identifier: http://orcid.org/0000-0002-6615-5035
authors.initials: RB
authors.lastname: Dewey
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Padraig E
authors.initials: PE
authors.lastname: O'Suilleabhain
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Manjit
authors.initials: M
authors.lastname: Sanghera
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Neepa
authors.initials: N
authors.lastname: Patel
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Pravin
authors.initials: P
authors.lastname: Khemani
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Laura H
authors.initials: LH
authors.lastname: Lacritz
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Chitnis
authors.affiliation: Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Louis A
authors.initials: LA
authors.lastname: Whitworth
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Dewey
mesh_terms: D003071:Cognition; D046690:Deep Brain Stimulation; D004421:Dystonia / Q000601:surgery*; D020329:Essential Tremor / Q000601:surgery*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000601:surgery*; D011184:Postoperative Period; D058996:Quality Improvement