To safely refer ED patients to outpatient MRI studies with appropriate PCP and/or Neurology follow-up when an emergent MRI is not clinically indicated during ED visit. 

Patients may present to ED for non-acute neurological complaints for which MRI may be indicated, but not emergently, in guiding diagnosis and treatment. However, the use of advanced diagnostic imaging in the ED is associated with increased healthcare cost, length of stay and overcrowding in the ED. To addresses these issues, we established a rapid outpatient MRI referral protocol allowing patients to receive a timely MRI and appropriate follow-up with PCP and/or Neurology. 

We conducted a retrospective review of patients referred to this program. We collected data on MRI appointment adherence, reasons for non-adherence, length of time to obtain an MRI, if significant findings were identified on MRI, and 72-hour return to ED rate. 

Between February 2021 and December 2023, 142 patients were referred through this program. 92 patients adhered to their MRI appointment, with the most common reason for non-adherence due to patient declining MRI after ED discharge. The median time to obtain an MRI after referral was 8 days. Fifteen patients had significant new findings that required follow-up and all were able to follow up with their PCP or a Neurology provider, with a median of 8 days from MRI to appointment. Overall 72-hour return to ED rate was 6%. One patient was called back to ED for admission to the neurology service for inpatient workup after MRI showed a significant finding.