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THUR 021 Transforming acute neurology: a 4 year study
  1. Nitkunan Arani,
  2. Macdonald Bridget,
  3. Bhoodoo Ajay,
  4. Southam Medina,
  5. Smyth Caitlyn,
  6. Tomkins Andrew,
  7. Schon Fred
  1. Croydon University Hospital, London, UK


We present a novel approach to acute neurological care. The key is an acute neurology triage nurse, based in the medical admission unit as well as an epilepsy specialist nurse seeing every patient referred with fits on the day of admission, a designated acute neurology consultant and acute neurophysiology and neuroradiology links. We have designated this group, a hyperacute neurology team (HANT).

This study compares all admissions in 2014, the year before the team was established with 2015–2017. The total number of referrals has increased from 720 in 2014 to 1248 in 2017. The percent of patients seen on the day of referral has risen from 59% in 2014 to 92% in 2017.

Average length of stay for patients with a primary diagnosis of epilepsy has gone down from 4.1 days in 2014 to 3.4 in 2017. Multiple admissions for epilepsy has reduced from 28 in 2014 to 21 in 2017. Patients suitable for early discharge are seen in consultant or nurse «outpatient hot clinics» or nurse telephone clinics.

The cost of establishing this service has been relatively small (£106,000) and the service benefits enormous. We feel this model is worthy of wider debate.

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