1. 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