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Abstract Details

Expanding the Inpatient General Neurology Consultation Service: An Initiative to Improve Care Delivery
Neurohospitalist
P6 - Poster Session 6 (11:45 AM-12:45 PM)
2-011
 To improve delivery of neurology consultation services at an urban academic hospital.
The volume of neurological consultations has grown annually, at a rate outpacing attending staffing capabilities, resulting in new consultations generally being prioritized over subsequent evaluations. At our hospital, follow-up recommendations have predominantly been made remotely via chart review and provider discussions. We identified an opportunity to improve care delivery by increasing in-person follow-up visits.
Based on chart review of all patients seen by the neurology consult service over a 4-week period in FY24, we estimated that on average, there were 5 patients daily who were not seen but would have benefited from in-person assessment after recommended testing resulted or to trend the neurologic exam. To improve care continuity while mitigating increasing consult volume, we expanded the general neurology consult service from a one-attending to two-attending model. The first attending is a dedicated neurohospitalist present throughout the week (Monday-Friday), and the second is a predominantly outpatient subspecialist who is on service on the weekend, all day Monday, and half days the remainder of the week. Having both a neurohospitalist and an outpatient attending on the consult service enhances the trainee educational experience by providing exposure to multiple subspecialists.
In FY24, the general consult service saw an average of 33.3 new consults (6.7/day) and 8.9 follow-ups (1.8/day) during the week. In the first 12 weeks of FY25 after service expansion, the combined general consult services saw an average of 42.3 new consults (8.5/day) and 31.4 follow-ups (6.3/day) during the week. On weekends, when there remains a single attending, the consult team saw an average of 2 follow-ups/day.
The addition of a second part-time consult attending has fulfilled a need for increased volume of neurological follow-ups and has improved continuity of care for patients and communication with primary teams.
Authors/Disclosures
Daniel Cristancho, MD (University of Pennsylvania)
PRESENTER 		Dr. Cristancho has nothing to disclose.
Denise J. Xu, MD (University of Pennsylvania) An immediate family member of Dr. Xu has received personal compensation for serving as an employee of Novartis.
Raymond Price, MD, FAAN (University of Pennsylvania) Dr. Price has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Price Lakeside. Dr. Price has received publishing royalties from a publication relating to health care.