Introduction Long-term video-EEG monitoring aids epilepsy management. Anti-epileptic drug reduction is often performed to increase event capture. Patient safety is paramount given the risk of injury or fatality. We completed 3 audit cycles of response times to seizures in our unit.

Methods ▸ First audit cycle (2012) – ten patients, 15 events – unit used for diagnosis only

▸ Epilepsy surgery business case approved (July 2013) – additional healthcare professional (HCP) employed to observe patient and room layout modified. Drug reduction regimens implemented.

▸ Second cycle (2014) - five patients, 24 events

▸ Third cycle (2014–15) – 33 patients, 117 events

Results Cycle 1: HCP responded to 9 of 14 clinically identifiable events (64%). Median 47 s, mean 317 s (range 18 s–28 minutes). No assessment of cognition.

Cycle 2: Response to 19 of 20 clinical events (95%). Median 12 s, mean 25 s (range 0–106 s). Orientation (6/24), motor task (3/24), and speech (2/24) assessed. Recall not assessed.

Cycle 3: Response to 104 of 106 clinical events (98%). Median 10 s, mean 35 s (range 0–150 s). Orientation (57/117), motor task (21/117), speech (90/117) and recall (33/117) assessed.

Conclusions Each cycle shows improved HCP response. Education and proforma introduction has improved interaction between HCPs and patients but ongoing improvements are needed.