To discuss strategies to improve access to neurological care at an academic center.

Neurological disorders are a leading cause of disease burden globally and there is an anticipated 19% shortfall of neurologists. Moreover, appointment delays increase emergency room visits. There is a pressing need to improve access to care and decrease appointment wait times. We led a departmental initiative to bridge the access gap.

We focused on three strategies: template management, leveraging APPs, and timely access for new patients. Template management included standardizing 4-hour sessions and visit durations, 2 new patients per session, aligning sessions with allocated clinical effort, and moving meetings away from session times. APPs were leveraged to manage care of established patients. Timely access: we blocked 30% of all available new slots (Frozen New slots) to allow scheduling 10 days prior to appointment. We used these slots to prioritize access for patients with acute/complex disorders, internal referrals from within our institution, and for programmatic growth of our subspecialty clinics.

Patient volume: Over a 2-year span, total patient volume increased from 27,746 to 37,173 (34%), and new patient volume grew from 5,178 to 6,814 (32%). APP patient volume grew from 8,825 to 13,997 (59%). The number of patient visits per clinic session grew from 4.32 to 5.22 for physicians (21%) and from 4.61 to 5.92 for APPs (28%). Timely Access: The number of new patients seen within 10 days grew from 19% to 40% (113% increase) for internal referrals and from 21% to 36% (67% increase) for all referrals.