RT Journal Article
SR Electronic
T1 Hyperacute neurology at a regional neurosciences centre: a 1-year experience of an innovative service model
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 119
OP 126
DO 10.7861/clinmedicine.19-2-119
VO 19
IS 2
A1 Kuven K Moodley
A1 Valerie Jones
A1 Mahinda Yogarajah
A1 Bhavini Patel
A1 Umesh Vivekananda
A1 Pablo Garcia-Reitboeck
A1 Kiran Samra
A1 Gillian Cluckie
A1 Oliver Foster
A1 Anthony C Pereira
A1 Niranjanan Nirmalananthan
YR 2019
UL http://www.rcpjournals.org/content/19/2/119.abstract
AB St George’s Hospital hyperacute neurology service (HANS) is a comprehensive, consultant-delivered service set in a teaching hospital regional neuroscience centre. The service addresses deficiencies in acute neurological care previously highlighted by the Royal College of Physicians and the Association of British Neurologists. HANS adopts a disease-agnostic approach to acute neurology, prioritising the emergency department (ED) management of both stroke and stroke mimics alike alongside proactive daily support to the acute medical unit and acute medical take. Rapid access clinics provide a means to assess ambulatory patients, providing an outlet to reduce the burden of referral from primary care to acute medicine. This paper reports the results from the first year of the service. Admission was avoided in 25% of the cases reviewed in the ED. Compared to historic data, there was a significant improvement in the length of stay for non-stroke disorders while the occupancy of stroke beds by non-stroke cases reduced by 50%. The configuration of this service is replicable in other neuroscience centres and provides a framework to reduce the barriers facing patients who present with acute neurological symptoms.