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Abstract Details

Improving Access and Care for Patients with Urgent Symptoms – The UVA NeuroFIRST Clinic Pilot
General Neurology
P7 - Poster Session 7 (8:00 AM-9:00 AM)
7-003

To provide timely care for patients with urgent needs at an academic medical center, a novel clinic model was launched in August 2025 for an eight-week pilot aimed at reducing wait times, decompressing an existing neurology clinic, and decreasing non-emergency ED visits. Pilot objectives included testing a novel scheduling model, validating a team-based approach, and optimizing efficiency.

Neurology clinics nationwide face capacity constraints and long wait times. Many lack clear protocols for urgent symptoms, leading patients to seek care in EDs or urgent care centers. This pilot sought to create a streamlined pathway for patients requiring timely neurological evaluation.

The clinic operated one half-day per week at a satellite location selected for accessibility. Team-based staffing included two APPs, one neurologist, one MA, and one nurse navigator. Any ED referral or urgent-flagged ambulatory referral was scheduled within 14 days without clinician screening. Templates were designed to allow the neurologist to see patients in between staffing APP encounters. Quality and performance metrics were compared to the prior academic year.

55 patients were evaluated. Sessions typically filled within 6 days. Median referral-to-appointment time was 22 days, a drastic improvement from the prior year median of 120 days. 62% of referrals came from EDs; headache, seizure, and somatosensory issues were the three most common referral reasons.

Upon evaluation, 80% had urgent symptoms, 84% had a neurological condition, and only 47% required neurology follow-up care.

100% of patients reported satisfaction, citing timely access as the most important factor. Providers reported 100% satisfaction with the team-based model.

The clinic pilot demonstrated feasibility, efficiency, and high satisfaction. Over half of patients did not need further neurology follow-up, reducing demand on the existing clinic. The scheduling process resulted in a 98-day reduction in wait times. This validates that expedited scheduling and team-based care can improve access and care.

Authors/Disclosures
Brett Schneider
PRESENTER
Mr. Schneider has nothing to disclose.
Jennifer Schach, NP Mrs. Schach has nothing to disclose.
Stephanie M. Gillan, NP (University of Virginia Medical Center) Ms. Gillan has nothing to disclose.
Jennifer Richmond, RN Mrs. Richmond has nothing to disclose.
Alexander Elias, MD Dr. Elias has nothing to disclose.
Kristine S. Ziemba, MD, PhD (University of Virginia) Dr. Ziemba has nothing to disclose.
Robert K. Shin, MD, FAAN Dr. Shin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Shin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sandoz. Dr. Shin has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Shin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for BMS. Dr. Shin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Shin has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for TG Therapeutics. Dr. Shin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Shin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen.
José H. Posas, MD, FAAN (UVA Department of Neurology) Dr. Posas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Pfizer. Dr. Posas has or had stock in Dane Health.Dr. Posas has or had stock in Brainscope.Dr. Posas has a non-compensated relationship as a Advisor with Dane Health that is relevant to AAN interests or activities. Dr. Posas has a non-compensated relationship as a Lecturer with Concussion Corner Academy that is relevant to AAN interests or activities. Dr. Posas has a non-compensated relationship as a Advisor with Brainscope that is relevant to AAN interests or activities.
Andrew M. Southerland, MD, FAAN (University of Virginia, Dept of Neurology) Dr. Southerland has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Plaintiffs and Defense Cases related to Stroke and Vascular Neurology.. The institution of Dr. Southerland has received research support from American Heart Association. The institution of Dr. Southerland has received research support from NIH. The institution of Dr. Southerland has received research support from Abbvie Pharmaceuticals, Inc.. Dr. Southerland has received intellectual property interests from a discovery or technology relating to health care. Dr. Southerland has received intellectual property interests from a discovery or technology relating to health care.
Xuemei Huang, MD, PhD (Univeristy of Virginia School of Medicine) Dr. Huang has received personal compensation for serving as an employee of NIH. Dr. Huang has received personal compensation for serving as an employee of DoD. The institution of Dr. Huang has received research support from NIH.