Abstract Details

Title Express Dementia Care in East Texas (EDCC): An Integrated, Closed-loop Model to Shorten Time-to-diagnosis and Improve Caregiver Outcomes

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-007

Objective To implement and evaluate a multidisciplinary “Express Dementia Care” pathway that (1) optimizes referrals with closed-loop PCP–specialist communication, (2) uses the wait period for structured assessment and lifestyle initiation, and (3) delivers a definitive diagnosis and written plan within a fixed time window, refined through Plan-Do-Study-Act (PDSA) cycles.

Background Rural patients face prolonged waits for specialty dementia care and fragmented services, amplifying caregiver burden and delaying timely intervention. East Texas lacks an integrated pathway that links primary-care, rapid pre-visit workup, and definitive behavioral neurology assessment within a single, coordinated model.

Design/Methods

Prospective implementation at UT Health North Campus, Tyler. The pathway comprises:

Referral optimization: standardized completeness metrics, feedback to PCPs, and specialty-visit targets from referral (T0): ≤8 weeks (Year 1), ≤6 weeks (Year 2).
Integrated pre-visit (≤2–3 weeks from T0): demographics and SDOH; cognitive screens (MoCA/MMSE, SMCQ, FAQ); mood (PHQ-4 ± PHQ-9/GAD-7); sleep (ISI-7, STOP-Bang); therapy needs (PT/OT/SLP/audiology); caregiver burden (ZBI-8); goal setting/barriers; immediate lifestyle counseling and referrals.
Behavioral neurology visit: complete diagnostic workup (serum labs, MRI, neuropsychology) and, when appropriate, biomarker-guided anti-amyloid eligibility counseling (PET amyloid/APOE).

All data are captured in REDCap; PDSA microcycles occur every 6 months with run/control charts. Pre-specified success thresholds (Months 0–24): ≥90% pathway completion ≤8 weeks, mean referral completeness ≥4.5/5, ≥3-point ZBI-8 reduction, ≥85% SDOH linkage, and Net Promoter Score ≥ +50.

Results We will report feasibility, fidelity to time targets, changes in referral completeness, caregiver burden, SDOH linkage rates, patient-reported outcomes, and stakeholder experience. Iterative PDSA changes (e.g., EMR hard-stops, dedicated MRI blocks, navigator scripting) will be described with pre/post process-control analyses.

Conclusions EDCC operationalizes a practical, exportable pathway for rural dementia care by compressing time-to-diagnosis, activating lifestyle and support services during the wait, and embedding continuous QI. If benchmarks are achieved, we will disseminate a living implementation toolkit to enable multisite replication across similar underserved regions.

Authors/Disclosures
Khushboo Verma, MBBS PRESENTER	Dr. Verma has nothing to disclose.
Haylee Voyles, RN	Mrs. Voyles has nothing to disclose.
Elisabeth Burnett, NP	Mrs. Burnett has nothing to disclose.
Satwant Kumar, MBBS, PhD (NeuroReef Labs)	Dr. Kumar has received personal compensation for serving as an employee of Neuroreef Labs . Dr. Kumar has stock in Neuroreef Labs.
Andrea Gohmert, Audiologist- Au D	Dr. Gohmert has nothing to disclose.
Andrew Schmitt, PhD	Dr. Schmitt has nothing to disclose.

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