The goal of this study was to identify the current process and characteristics of PWE receiving workplace and academic letters of accommodation at UNC Health. Through this analysis, we hope to set the stage for quality improvement projects that will ensure a valid and efficient process for writing academic and workplace letters of accommodation. We have a few recommendations for UNC Health to improve the reporting and dissemination of reasonable accommodations for PWE. The basis for our recommendations comes from the Health Belief Model, which aims to articulate individual beliefs about disorders. The model is made up of six constructs, four of which include perceived barriers, perceived benefits, self-efficacy, and cues to action (Champion & Skinner, 2008). If patients have a letter of accommodation, we believe that it will eliminate perceived barriers and enhance their perceived benefits.
To increase medical providers’ self-efficacy in writing letters of accommodation, our first recommendation is to provide training on proper academic and workplace accommodations for people with various disorders, including epilepsy. The training should be comprehensive and address the following: when accommodations are warranted, what to include in the letters, the ease of writing them, the kinds of accommodations that may be requested for school-aged and adult populations, the benefits that children and adults receive from them, and how to avoid unnecessary accommodations. Unnecessary accommodations give an unfair advantage to students and employees and are an extra burden on teachers and employers. The goal of this training would be to increase confidence in medical providers’ ability to write valid letters of accommodation (Champion & Skinner, 2008).
The training will ensure that medical providers are prepared for our second
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patients with any chronic condition if they need academic or workplace accommodations. This would be the cue to action for medical providers to carry out the action of writing a letter of accommodation (Champion & Skinner, 2008), which will hopefully increase the percentage of letters of accommodation on file, and lead to improved patient quality of life.
Our final recommendation is that UNC Health add a box on the Snapshot page in Epic indicating any letters of accommodation on file for patients. This would help prompt physicians to ask their patients about any accommodations on file at follow-up visits in case any changes need to be made. In addition, it would improve the labeling and ease of access to any letters of accommodation. The overall purpose of each recommendation is to improve the quality of life for PWE and help facilitate the dissemination of letters of accommodation.
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APPENDIX
Table B: Data Collection Chart Headings
MRN#
Current Age
Gender Race Primary Language Ethnicity Student (Y/N) Employed, Self- Employed, Not Employed, Retired, Disabled, or Not Listed Full or Part-Time Occupation (F/P) Prior Comorbidities (Y/N) Medically Managed Epilepsy (Y/N) Accommodation Letter on File (Y/N) Title of Medical Provider (i.e. neurologist, OT) Employer Response on File (Y/N) Affirmative Response from Employer Negative Response from Employer School Response on File (Y/N) Affirmative Response from School Negative Response from School *Accommodation *Will be added as letters of accommodation are discovered
33
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