Neurology Access Clinic: A Study of Neurologist and Advanced Practice Provider Collaboration in a Tertiary Academic Setting
Bruna Leles Vieira de Souza1, Joao Vitor Mahler1, Sergi Martinez-Ramirez1, Andrea Thurler1, Sarbesh Chalise1, Christina Maheras1, Kasey O’Keefe1, Michael Erkkinen1, Bruce Kastin1, Lidia Maria Moura1, Marcelo Matiello1
1Mass General Brigham
Background:
The global burden of neurological diseases continues to rise, contributing significantly to morbidity and mortality. As the population ages, healthcare systems face challenges in providing timely neurological care and reduce long wait times and overburdened urgent care settings. Neurology Access clinics have emerged as a partial solution to improve access. This study describes the operational framework and implementation features of the Mass General Brigham Neurology Access Team (NeAT) clinic through a multidisciplinary approach.
Design/Methods:
We conducted a retrospective review of all NeAT clinic visits from November 2023 to April 2024 at our institution. Clinic sessions were organized into one-week blocks, each consisting of eight four-hour sessions, accommodating four new patients per session. An advanced practice provider (APP) was available for follow-up referrals. Data collected included patient demographics, lag time to consultation, reason for referral, neurological diagnosis, time to follow-up, and disposition after the initial visit. Descriptive statistics summarized clinic operations, patient flow, and outcomes.
Results:
A total of 184 visits were scheduled, with 154 completed. The average time from referral to the first appointment was 81.4 days. Most referrals (70.1%) came from primary care clinicians, 21.4% from specialists, and 8.4% from emergency departments. Common complaints included headaches (27.7%), neuromuscular issues (24.5%), and cognitive problems (20%). Notably, 63% of patients did not require a second visit. Dispositions included return to primary care (23.7%), follow up with APP (16.7%), or a neurologist (37.2%), while 19.9% were referred to subspecialty care in neurology.
Conclusions:
This clinic model efficiently managed a variety of neurological cases in a single visit, highlighting its potential to optimize resource use and improve access to specialized care. However, long wait times and a high demand for neurology care remain a challenge, warranting further prospective and controlled interventions.
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