The 'hidden work' of a hospital neurologist: 1000 consults later.
Affiliation
Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin,, Ireland.Issue Date
2012-02-01T10:33:24ZMeSH
*Computer Communication Networks/statistics & numerical data*Electronic Health Records/statistics & numerical data
Emergency Medical Services/methods/statistics & numerical data
Humans
Inpatients/statistics & numerical data
Neurology/*methods/statistics & numerical data
*Referral and Consultation/statistics & numerical data
Time Factors
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Show full item recordCitation
Eur J Neurol. 2010 Apr;17(4):e28-32. Epub 2009 Dec 29.Journal
European journal of neurology : the official journal of the European Federation, of Neurological SocietiesDOI
10.1111/j.1468-1331.2009.02901.xPubMed ID
20050903Abstract
BACKGROUND: A new Web-based, internal neurology referral service was introduced in our department to expedite inpatient review for other departments and to allow assessment of the impact of neurology consults on patient care throughout the hospital, especially in the emergency department (ED). The results of the analysis of the first 1000 referrals using the new system are presented. Methods: An intranet referral system was designed by the consultant neurologists. The previous method of referral was by handwritten letter. The electronic template included 'drop-down' menus and mandatory fields to help guide referring teams. An outcome section is completed by the neurology team. Results: An average of 17 referrals was seen weekly. Seventy-seven per cent were seen within 24 h of referral. A consultant neurologist saw 87% of the referrals directly; 13% were first seen by a registrar and later discussed with a consultant. Forty per cent were seen in the ED of which a one-third of the patients were discharged following assessment. The most common reason for referral was seizure(s) or an episode of collapse (28%). Patients presenting with stroke/transient ischaemic attack represented 13.5%, and 12.5% presented with headaches. The management of 79% of referred cases was deemed to have been significantly changed after neurology review. Discussion: The introduction of a neurology consultant-designed and consultant-led intranet referral service has greatly enhanced the delivery of the consult service to patients in our hospital. This referral system contributes significantly to hospital efficiency and to access for patients to specialist assessment.Language
engISSN
1468-1331 (Electronic)1351-5101 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1111/j.1468-1331.2009.02901.x
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