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Abstract Details

Complex Case Conference: Implementation and Evaluation of a Novel Approach to Enhance Inter-specialty Clinical Collaboration within a Department of Neurology
好色先生, Research, and Methodology
P11 - Poster Session 11 (11:45 AM-12:45 PM)
15-002
To report results eighteen months after implementation of the Complex Case Conference (CCC), a monthly dedicated forum for inter-specialty clinical case discussion. 
The field of neurology is becoming increasingly subspecialized as the knowledge needed to care for neurology patients expands rapidly. Neurologists are thus increasingly encountering challenging, undifferentiated cases which may not fit clearly within a single subspecialty. Few formalized opportunities exist for neurologists to present complex cases to peers with differing expertise, especially in departments spread across multiple sites. 
Informed by a survey-based needs assessment, [1] we initiated CCC. CCC was held monthly for 60 minutes, during protected departmental time for Grand Rounds. The forum was moderated and consisted of 30 minutes dedicated to a case selected in advance, and 30 minutes dedicated to serve as an open forum for active cases. Pre- and post-implementation surveys were administered to residents and faculty to assess the impact of this initiative.
Twelve neurology residents and attendings completed the pre-implementation survey;  22 residents and attendings completed the follow-up survey. A significantly higher proportion of respondents felt they had a good mechanism to discuss challenging cases within their subspecialty (p=0.002) and with other subspecialties (p=0.036) after implementation. There was a significant increase in knowledge of what resources exist across the institution (e.g. specialty lab tests and imaging studies) (p=0.009). There was a non-significant increase in intra-departmental referrals and recognition of cases where multispecialty input would be beneficial.
After 18 months of CCC, respondents noted an improvement in intra- and cross-specialty clinical collaboration on complex clinical cases. There was an increase in institutional knowledge pertinent to clinical care. CCC offers a feasible strategy for enhancing care for patients who may benefit from multispecialty expertise. CCC has become a valuable attending-driven forum for supporting complex patient care while enhancing clinician growth, institutional knowledge, and collaboration.
Authors/Disclosures
Harli Weber, MD
PRESENTER 		Ms. Weber has nothing to disclose.
Galina Gheihman, MD (Brigham & Women's Hospital) Dr. Gheihman has nothing to disclose.
Gabriel B. Rodriguez, PhD, MSPH Dr. Rodriguez has received research support from American Public Health Association.
Tracey A. Milligan, MD, FAAN Dr. Milligan has received publishing royalties from a publication relating to health care.
Stephanie Gandelman, MD Dr. Gandelman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Gandelman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen.