Implementation of a Dedicated Center for Neurologic Emergency Medicine Mitchell J. Rubin, MD | Phyllis O’Neill, RN, BSN, FN-CSA | Geri Sanfillippo, RN, BSN Capital Health Regional Medical Center, Trenton, NJ The names and addresses of PRIMARY GOALS HOW THE PROGRAM WAS IMPLEMENTED POPULATION SERVED Identify all Neurological Emergencies Rapidly and Comprehensively Treat Neurological Emergencies Reduce or Eliminate Wait Times from Door to Triage Reduce or Eliminate Door to Doc Time Reduce Door to Needle Time for Patients requiring Thrombolytics The Center for Neurologic Emergency Medicine, the first documented program of its kind in the US, was implemented on January 3, 2011 under the leadership of Drs. Erol Veznedaroglu, Mitchell Rubin, and Michael D’Ambrosio. A specially trained team, placed within a general emergency department, who are dedicated to the goal of providing rapid identification of the needs of neurological patients and assuring that they receive the specific and time sensitive treatments that are required. Strokes Migraines Dizziness/Vertigo Headache with or without fever Back pain with neurological signs/symptoms Seizures Head/Spine trauma injury Coma Visual loss/disturbance Sensory disturbances-numbness Muscle and or focal weakness ACTIVITIES TO MEET IDENTIFIED NEEDS 40% INCREASE IN VOLUME OF STROKE /TIA PATIENTS Hiring qualified and board certified physicians Partnering with nursing and identifying appropriate staff support Developing precise triage criteria Securing emergency department designated space Diagnostic resources 24/7 advanced functional neuro-imaging Dedicated neuro-radiologist Tele-neurology Capability of 24 hour EEG monitoring IMPROVED tPA MEASURES Neurological ED Visit Statistics 2011 Totals Days of Physician Coverage 339 ED Visits 2373 ED Admissions 1011 Admission Percentage 42.6% DECREASE IN THROUGHPUT TIMES; 16% STROKE /42% TIA DECREASE IN LENGTH OF STAY ACUTE STROKE NEURO ED VISIT STATISTICS 2011 Conclusion Neuro ED Visit Statistics Literature Cited   Acknowledgements