The 'hidden work' of a hospital neurologist: 1000 consults later.

Hdl Handle:
http://hdl.handle.net/10147/207631
Title:
The 'hidden work' of a hospital neurologist: 1000 consults later.
Authors:
Ali, E; Chaila, E; Hutchinson, M; Tubridy, N
Affiliation:
Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin,, Ireland.
Citation:
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 Societies
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207631
DOI:
10.1111/j.1468-1331.2009.02901.x
PubMed ID:
20050903
Abstract:
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:
eng
MeSH:
*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
ISSN:
1468-1331 (Electronic); 1351-5101 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorAli, Een_GB
dc.contributor.authorChaila, Een_GB
dc.contributor.authorHutchinson, Men_GB
dc.contributor.authorTubridy, Nen_GB
dc.date.accessioned2012-02-01T10:33:24Z-
dc.date.available2012-02-01T10:33:24Z-
dc.date.issued2012-02-01T10:33:24Z-
dc.identifier.citationEur J Neurol. 2010 Apr;17(4):e28-32. Epub 2009 Dec 29.en_GB
dc.identifier.issn1468-1331 (Electronic)en_GB
dc.identifier.issn1351-5101 (Linking)en_GB
dc.identifier.pmid20050903en_GB
dc.identifier.doi10.1111/j.1468-1331.2009.02901.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207631-
dc.description.abstractBACKGROUND: 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.en_GB
dc.language.isoengen_GB
dc.subject.mesh*Computer Communication Networks/statistics & numerical dataen_GB
dc.subject.mesh*Electronic Health Records/statistics & numerical dataen_GB
dc.subject.meshEmergency Medical Services/methods/statistics & numerical dataen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInpatients/statistics & numerical dataen_GB
dc.subject.meshNeurology/*methods/statistics & numerical dataen_GB
dc.subject.mesh*Referral and Consultation/statistics & numerical dataen_GB
dc.subject.meshTime Factorsen_GB
dc.titleThe 'hidden work' of a hospital neurologist: 1000 consults later.en_GB
dc.contributor.departmentDepartment of Neurology, St Vincent's University Hospital, Elm Park, Dublin,, Ireland.en_GB
dc.identifier.journalEuropean journal of neurology : the official journal of the European Federation, of Neurological Societiesen_GB
dc.description.provinceLeinster-

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