To reduce burden of neurology patients on the emergency room and to expedite outpatient access

Emergency room and hospital overcrowding, combined with a lack of access to Neurology clinics can adversely affect the functionality of healthcare institutions. To reduce this burden we piloted a rapid-referral program from the Emergency room to Neurology clinic to improve patient throughput. 

We created a Fast Neuro pool at UCLA that could be accessed from the emergency room as well as the call center where all outside neurology calls and referrals are filtered and reviewed. We used the excel sheet to track referral classification, date received, where it came from and no-show to clinic rates. All requests were routed to a provider, who triaged and scheduled patients for a clinic visit. In addition, surveys were sent to Neurology residents and attendings to assess the effect of Fast neuro patients on clinic burden at 3 and 6 months.

Over six months, 120 patients were referred to Fast Neuro. 57% were referred from the UCLA emergency department, 24% from other emergency departments, and 19% were internal referrals. All referrals were seen within 7 days of receiving a Fast neuro request and within 15 days of initial presentation.  Prior wait time was over 30 days. Resident surveys indicated that 89% felt Fast Neuro patients did not detract from their clinic experience, 77% indicated that Fast Neuro patients did not make it more difficult to care for patients, and 100% of residents stated Fast Neuro patients helped fill cancelled appointments, compared to 100% of attendings in each category.

The Fast Neuro model of care improved emergency room throughput and allowed urgent evaluations to be seen within 15 days of Emergency room presentation without detracting from the quality of clinic cases or significantly increasing the workload of Neurology clinic.