Background And Purpose: The purpose is to determine the impact of an academic neurohospitalist service on clinical outcomes.
Methods: We performed a retrospective, quasi-experimental study of patients discharged from the general neurology service before (August 2010-July 2014) and after implementation of a full-time neurohospitalist service (August 2016-July 2018) compared to a control group of stroke patients. Primary outcomes were length of stay and 30-day readmission. Using the difference-in-difference approach, the impact of introducing a neurohospitalist service compared to controls was assessed with adjustment of patients' characteristics. Secondary outcomes included mortality, in-hospital complications, and cost.
Results: There were 2706 neurology admissions (1648 general; 1058 stroke) over the study period. The neurohospitalist service was associated with a trend in reduced 30-day readmissions (ratio of ORs: .52 [.27, .98], = .088), while length of stay was not incrementally changed in the difference-in-difference model (-.3 [-.7, .1], = .18). However, descriptive results demonstrated a significant reduction in mean adjusted LOS of .7 days (4.5 to 3.8 days, < .001) and a trend toward reduced readmissions (8.9% to 7.6%, = .42) in the post-neurohospitalist cohort despite a significant increase in patient complexity, shift to higher acuity diagnoses, more emergent admissions, and near quadrupling of observation status patients. Mortality and in-hospital complications remained low, patient satisfaction was stable, and cost was not incrementally changed in the post-neurohospitalist cohort.
Conclusions: Implementation of a neurohospitalist service at an academic medical center is feasible and associated with a significant increase in patient complexity and acuity and a trend toward reduced readmissions.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9214938 | PMC |
| http://dx.doi.org/10.1177/19418744221083182 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
CONNECT: Coordinating Options for Neurovascular Patients Needing Electrophysiology Consults and Treatments.
Neurohospitalist
September 2024
Department of Neurosciences, University of California, San Diego, CA, USA.
Background And Purpose: Though Event Monitors (EM) and Implantable Loop Recorders (ILR) are prevalent in stroke workups, complex processes to obtain placement of these device might result in delays. Our aim was to determine if the CONNECT (Coordinating Options for Neurovascular patients Needing Electrophysiology Consults and Treatments) pathway could improve Stroke-to-Electrophysiology (EP) communications, increase EM and ILR device placements prior to discharge, shorten placement time, and preserve satisfaction.
Methods: We assessed device placements when an EP consult was obtained [Pre-CONNECT (5/1/21-4/30/22), CONNECT (5/1/22-4/30/23)] for patients with stroke.
Patterns of Arterial Wall Lesions in Eagle Syndrome: Case Series and Literature Review.
Neurohospitalist
October 2024
Unité neurovasculaire, CHU Nantes, Nantes, France.
Article Synopsis
- Eagle syndrome involves the impingement of an elongated styloid process or calcified stylohyoid ligament on neck structures, impacting vascular elements, known as stylocarotid syndrome, is less understood by doctors.
- A review of cases at the hospital showed five instances of vascular issues linked to Eagle syndrome, including serious conditions like carotid perforation and internal carotid dissections.
- There's a call for a unified definition of Eagle syndrome to improve diagnosis and treatment, with styloidectomy often used for compression, but further research is needed for other circumstances.
Education Research: Educational Outcomes Associated With the Introduction of a Neurohospitalist Program.
Neurol Educ
June 2024
From the Department of Neurology & Neurological Sciences (S.D., B.J.S., C.A.G., K.A.K.), and Quantitative Sciences Unit (Y.W.), Stanford University, CA.
Article Synopsis
- The study investigates how the establishment of a neurohospitalist (NH) service impacts neurology resident evaluations of faculty teaching before and after its implementation.
- Researchers conducted a retrospective analysis, comparing faculty evaluations from two distinct periods: before the NH model (2010-2014) and after its implementation (2016-2018), while also examining related student evaluations and performance metrics.
- Results showed that resident evaluations of faculty teaching significantly improved in 19 out of 27 areas post-NH service, particularly in competencies like patient care and practice-based learning, while medical student evaluations remained unchanged.
Rates of Acute Brain Injury Among Severely Hypertensive Patients Seen in the Emergency Department.
Neurohospitalist
October 2024
Clinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
Background: Identifying patients with acute brain injury among patients who present to the Emergency Department (ED) with severe hypertension can be challenging. We explored rates of brain injury in a cohort of ED patients with severe hypertension in whom acute target-organ damage was or was not initially suspected.
Methods: We conducted a retrospective chart-review study at two different hospitals within the same urban health system.
Differences in Interfacility Transfer from Emergency Department and Inpatient Services for Inpatient Neurologic Care.
Neurohospitalist
October 2024
Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
Introduction: Interhospital transfer is an important mechanism for improving access to specialized neurologic care but there are large gaps in our understanding of interhospital transfer for the management of non-stroke-related neurologic disease.
Methods: This observational study included consecutive patients admitted to an adult academic general neurology service via interhospital transfer from July 1, 2015 to July 1, 2017. Characteristics of the referring hospital and transferred patients were obtained through the American Hospital Association Directory, a hospital transfer database maintained by the accepting hospital, and the electronic medical record.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!