Neurology clinic eases ED pressure

An emergency department based rapid access neurology clinic has reduced unnecessary admissions and out-of-hours neurology consultations and improved the quality of patient care, Australian researchers report. Practitioners at the Royal Prince Alfred Hospital tested the new clinic and referral system – the ED Rapid Access Neurology (ED RAN) clinic - for 12 months to assess patient satisfaction and determine whether it could ease service impacts in Australian hospital systems. The service, which was conducted once a week as a public outpatient clinic, offered patients who were considered safe for discharge from the ED with specialist neurology reviews within five days of leaving hospital. Of 222 patients who attended the clinic, a number of serious neurological diagnoses were made that had not been considered in the ED. Eight patients required admission after their specialist review, and all patients said the service was helpful. Consultant ED physicians estimated the clinic prevented 83 unnecessary admissions, saved nearly 200 after-hours neurology registrar consultations and cut more than 800 hours of ED bed time. “The clinic appears to provide a better service to patients, more support to ED staff at a time when there is less specialist knowledge available… and may offer potentially significant cost-saving opportunities,” the researchers said. “The ED RAN clinic provides a viable model for improving the quality of patient care and may also help to address the major problem of access block faced by most public hospitals in Australia,” they concluded. Practitioners are now lobbying for the model to be reviewed so it may be expanded to other Australian hospitals. MJA 2010; 192 (1): 30-32...