Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care

Costelloe, L.; O’Rourke, D.; Monaghan, Thomas; McCarthy, Allan; McCormack, Ryan; Kinsella, John; Smith, Adam B.; Murphy, Raymond P.; McCabe, Dominick J. H.

doi:10.1007/s11845-010-0555-6

Cited by 11 publications

(11 citation statements)

References 6 publications

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“…[1][2][3][4][5][6][7][8] In our study, the diagnosis of stroke was established in 12% of cases and this might not represent misdiagnosis, as it is fairly common to evaluate strokes that occur after admission (i.e. complication of cardiothoracic surgery).…”

Section: Discussionmentioning

confidence: 99%

A Neurologist’s Hard Day’s Work: Impact of Inpatient Neurology Consultation in a Tertiary Hospital

et al. 2016

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Introduction: Consultation of hospitalized patients under the responsibility of other specialties is a very demanding work. However, it is often under-recognized and poorly documented. The aim of the present study was to assess the burden of the inpatient neurology consultation in a Portuguese hospital and to evaluate the performance of our Neurology department regarding this issue. Material and Methods: A retrospective study was conducted during 2013, reviewing clinical and demographic data. Results: Over one year, the neurologists of our department evaluated 632 inpatients. The commonest reasons for consultation were altered mental state/behavior, focal neurological deficit and seizures. Requests came mainly from medical departments but also from Intermediate and Intensive Care Units. Neurologists suggested further investigation in almost one half of patients and management changes in a similar proportion of patients. A new diagnosis could be established in 63% of cases and the most frequent diagnosis were neurological manifestations of systemic disorders, epilepsy and cerebrovascular disease. Our intervention had impact on the care of 68% of patients. Discussion and Conclusion: Different studies in the literature support our findings and highlight the economic and patient care benefits of this activity. Our results suggest that neurological inpatient observation generates useful interventions for the clinical management of these patients.

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Section: Discussionmentioning

confidence: 99%

A Neurologist’s Hard Day’s Work: Impact of Inpatient Neurology Consultation in a Tertiary Hospital

et al. 2016

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“…However, very few studies have addressed the impact of the hospital neurologist on the evaluation of patients hospitalized under the supervision of other specialties, excluding the ED. [1][2][3][4][5][6][7][8] Those particular studies (summarized in Table 3) were mainly performed in Ireland and the United Kingdom, countries where the number of neurologists per 100 000 population is lower as compared to the rest of Europe. 9 Comparisons between those studies must be made with caution, since sample population and background facilities substantially differ.…”

Section: Discussionmentioning

confidence: 99%

“…Different authors reported a significant impact as well. [1][2][3][4][5][6][7][8] Others realized that after neurological evaluation, discharge was expedited in a significant percentage of patients (two-thirds to one half), resulting in major savings in resources. 5,7 These advantages are also highlighted by the 'neurohospitalist model', which advocates that the existence of neurologists especially dedicated to inpatients has economic and patient care benefits.…”

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confidence: 99%

“…[1][2][3][4][5][6][7][8] Others realized that after neurological evaluation, discharge was expedited in a significant percentage of patients (two-thirds to one half), resulting in major savings in resources. 5,7 These advantages are also highlighted by the 'neurohospitalist model', which advocates that the existence of neurologists especially dedicated to inpatients has economic and patient care benefits. 13,14 The main limitations of our study are its retrospective nature, a possible selection bias, as only electronically registered consultations were analyzed, and the absence of long term follow-up that might attest to the positive impact of the intervention by the Neurologist.…”

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confidence: 99%

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A Neurologist’s Hard Day’s Work: Impact of Inpatient Neurology Consultation in a Tertiary Hospital

et al. 2016

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Introduction: Consultation of hospitalized patients under the responsibility of other specialties is a very demanding work. However, it is often under-recognized and poorly documented. The aim of the present study was to assess the burden of the inpatient neurology consultation in a Portuguese hospital and to evaluate the performance of our Neurology department regarding this issue. Material and Methods: A retrospective study was conducted during 2013, reviewing clinical and demographic data. Results: Over one year, the neurologists of our department evaluated 632 inpatients. The commonest reasons for consultation were altered mental state/behavior, focal neurological deficit and seizures. Requests came mainly from medical departments but also from Intermediate and Intensive Care Units. Neurologists suggested further investigation in almost one half of patients and management changes in a similar proportion of patients. A new diagnosis could be established in 63% of cases and the most frequent diagnosis were neurological manifestations of systemic disorders, epilepsy and cerebrovascular disease. Our intervention had impact on the care of 68% of patients. Discussion and Conclusion: Different studies in the literature support our findings and highlight the economic and patient care benefits of this activity. Our results suggest that neurological inpatient observation generates useful interventions for the clinical management of these patients.

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“…Liaison neurology has no strict definition, but the term has been used to describe the consultation service where neurologists are asked to see inpatients under general medicine and other specialties as inpatient referrals. While a few services offer dedicated neurology beds for all patients with neurological disease and stroke, 8 most patients in the UK and across the world 9–20 who are admitted with neurological disorders are cared for by general physicians. Thus, the main way for inpatients to access specialist neurological opinion is by referral through a liaison neurology service.…”

Section: Introductionmentioning

confidence: 99%

Improving liaison neurology services

Fuller

2020

Pract Neurol

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Liaison neurology (consulting with inpatient ward referrals) is the main way that most patients admitted with neurological disease will access neurology services. Most liaison neurology services are responsive, seeing referrals on request, but they also can be proactive, with a regular neurology presence in the acute medical unit. Fewer than half of hospitals in England have electronic systems, yet these can facilitate the process—allowing electronic responses to advise on investigations before seeing the patient, and arranging follow-up after—as well as prioritising referrals and documenting the process. In this time of COVID-19, there are additional benefits in providing prompt remote advice. Improving the way liaison neurology is delivered can improve patient outcomes and save money by shortening admissions. This hidden work of the neurologists needs to be recorded and recognised.

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Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care

Abstract: Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

Cited by 11 publications

References 6 publications

A Neurologist’s Hard Day’s Work: Impact of Inpatient Neurology Consultation in a Tertiary Hospital

A Neurologist’s Hard Day’s Work: Impact of Inpatient Neurology Consultation in a Tertiary Hospital

A Neurologist’s Hard Day’s Work: Impact of Inpatient Neurology Consultation in a Tertiary Hospital

Improving liaison neurology services

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