Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul;17(4):298-302.
doi: 10.7861/clinmedicine.17-4-298.

A hyperacute neurology team - transforming emergency neurological care

Arani Nitkunan  1 , Bridget K MacDonald  2 , Ajay Boodhoo  2 , Andrew Tomkins  2 , Caitlin Smyth  2 , Medina Southam  2 , Fred Schon  2
Affiliations

A hyperacute neurology team - transforming emergency neurological care

Arani Nitkunan et al. Clin Med (Lond). 2017 Jul.

Abstract

We present the results of an 18-month study of a new model of how to care for emergency neurological admissions. We have established a hyperacute neurology team at a single district general hospital. Key features are a senior acute neurology nurse coordinator, an exclusively consultant-delivered service, acute epilepsy nurses, an acute neurophysiology service supported by neuroradiology and acute physicians and based within the acute medical admissions unit. Key improvements are a major increase in the number of patients seen, the speed with which they are seen and the percentage seen on acute medical unit before going to the general wards. We have shown a reduced length of stay and readmission rates for patients with epilepsy. Epilepsy accounted for 30% of all referrals. The cost implications of running this service are modest. We feel that this model is worthy of widespread consideration.

Keywords: Emergency care; hyperacute; neurology; neurology specialist nurse.

PubMed Disclaimer

Figures

Fig 1.
Fig 1.
Referrals to the hyperacute neurology team 2014–16. A – mean monthly referrals; B – percentage of patients seen on the acute medical unit; C – percentage of patients seen on day of referral.
Fig 2.
Fig 2.
Diagnosis for patients seen by the hyperacute neurology team.
Fig 3.
Fig 3.
Time from neurophysiology referral to electroencephalogram (EEG) and electromyogram (EMG).
See this image and copyright information in PMC

Comment in

  • The hyperacute neurology team.
    Cookson J. Cookson J. Clin Med (Lond). 2017 Dec;17(6):591. doi: 10.7861/clinmedicine.17-6-591b. Clin Med (Lond). 2017. PMID: 29196376 Free PMC article. No abstract available.
  • The hyperacute neurology team.
    Whiteside D. Whiteside D. Clin Med (Lond). 2017 Dec;17(6):591-592. doi: 10.7861/clinmedicine.17-6-591c. Clin Med (Lond). 2017. PMID: 29196377 Free PMC article. No abstract available.
  • Response.
    Nitkunan A, MacDonald BK, Boodhoo A, Tomkins A, Smyth C, Southam M, Schon F. Nitkunan A, et al. Clin Med (Lond). 2017 Dec;17(6):592. doi: 10.7861/clinmedicine.17-6-592. Clin Med (Lond). 2017. PMID: 29196378 Free PMC article. No abstract available.

References

    1. The Neurological Alliance Neuro numbers. London:: The Neurological Alliance; 2014. www.neural.org.uk/store/assets/files/381/original/Final_-_Neuro_Numbers_.... [Accessed 12 May 2017]
    1. Royal College of Physicians Report of a working party. London:: RCP; 2011. Local adult neurology services for the next decade.
    1. Reveruzzi B. Pilling S. Davie C. Sud P. Hyper acute neurology unit (HANU) evaluation. London:: UCL Partners; 2016. www.londonscn.nhs.uk/wp-content/uploads/2016/10/HANU-Evaluation-Final-Re.... [Accessed 12 May 2017]
    1. Gregory R. Nicholl D. Lawrence J. London: Association of British Neurologists. Acute Neurology services survey. 2017;2017
    1. Noble A. McCrone P. Seed PT. Goldstein LH. Ridsdale L. Clinical and cost-effectiveness of a nurse led self-management intervention to reduce emergency visits by people with epilepsy. PLoS ONE. 2014;9:e90789. - PMC - PubMed

MeSH terms