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Referrals, Wait Times and Diagnoses at an Urgent Neurology Clinic over 10 Years

Published online by Cambridge University Press:  23 September 2014

D.J. Wile ,
J. Warner ,
W. Murphy ,
A.L. Lafontaine ,
A. Hanson  and
S. Furtado
D.J. Wile
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta
J. Warner
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta
W. Murphy
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta
A.L. Lafontaine
Affiliation:
Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
A. Hanson
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta
S. Furtado
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta
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Abstract

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Background:

An urgent neurology assessment clinic was created at our institution to improve access to prompt neurological assessment, and has been in operation for over a decade. We assessed its timeliness and impact.

Methods:

The clinic database was examined retrospectively for trends in the volume and waiting time to assessments, neurologic diagnoses, and whether neurologic assessment changed patients’ diagnoses. Before and after implementation, the frequency of emergency department neurology assessments and hospital admissions for neurological investigation were compared.

Results:

In the first decade, 25145 referrals were received; 12460 patients were accepted and assessed within an average of 3.8 working days. The most common problems seen included headache and seizure (20.2% each). Overall, 44.6% of assessments resulted in a change to the referring diagnosis; this proportion varied by the type of problem seen (from 10.5% for seizures to 92.5% for psychiatric disturbances). From the pre- to post-opening periods, there were fewer emergency room neurological assessments (35.7% reduction) and fewer hospital admissions for neurological investigation (4.4/week to 2.2/week, 50% reduction).

Conclusions:

The urgent neurology clinic model at our institution has provided excellent service, including wait times of a few days, to a catchment of over two million Canadians for over a decade; clinic assessments have affected diagnoses and patient care.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 2 , March 2014 , pp. 260 - 264
Copyright
Copyright © The Canadian Journal of Neurological 2014

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