Neurology Access Clinic: A Model to Improve Access to Neurologic Care in an Academic Medical Center.

Abstract

Delays in access to neurologic care are a major problem. In this pilot program, we aimed to evaluate the effectiveness of a novel staffing model for neurology outpatient clinic within an academic neurology center to increase access to neurologic care, while incorporating such a model into a growing academic neurology department. We created a new model for provision of access to neurologic care that could be introduced in an academic neurologic department, the access clinic. One attending was assigned to staff the access clinic for 1 week at a time. This was introduced as rotation equal to conventional on-service inpatient rotations. Descriptive analyses were performed to characterize the access clinic's performance characteristics. Comparisons were made to the previously established traditional faculty clinic model. A total of 5,917 access clinic visits were compared with 6,000 traditional clinic visits. Lead time dropped from 142 to 18 days for new patients and from 64 to 0 days for return visits. Although total readmission rates were similar during both clinic periods, readmission through the emergency department was less for access clinic patients. The access clinic resulted in significant improvement in patient satisfaction ratings. The access clinic model was financially profitable. Our findings suggest that introducing an access clinic as service rotation for neurology faculty is both effective in offering enhanced access for patients to neurologic care and for patient satisfaction. Future studies may test this model in other centers and should address the effect on provider satisfaction.