Objective:

Background:

Clinical neurology is becoming increasingly subspecialized, with most residents pursuing fellowship training in one of 31 accredited and non-accredited programs. Yet, both inpatient and outpatient neurologists will continue to encounter challenging, undifferentiated cases which do not fit clearly within a single subspecialty. Few formalized opportunities exist for neurologists to access peer discussion regarding complex cases, especially in departments spread across multiple sites.

Design/Methods:

We surveyed all neurology residents and attendings at our multisite academic institution to understand the perceived need and desire for a formalized, inter-specialty clinical conference. We subsequently implemented a novel monthly forum informed by these results.

Results:

Twelve neurologists completed the survey (5 residents, 7 attending physicians), ranging from one to 34 years in practice. In the preceding month, most respondents (9/12) endorsed having at least one case where multispecialty input would have been helpful. Only four participants had a good mechanism to discuss challenging cases within their subspecialty; only five had a good mechanism for inter-specialty discussion. The CCC was developed to address these needs. Held during protected academic time, this forum is one hour in length: 30 minutes address a dedicated case selected in advance, followed by 30 minutes of an open forum for pressing cases. Preliminary evaluation suggests engagement is high. Participants feel CCC positively influences care and professional collaboration. CCC discussions have led to diagnostic testing, referrals, and changes in management.

Conclusions:

In response to an institutional needs assessment, a monthly CCC was developed to provide a dedicated forum for neurologists to gain peer review and inter-specialty input. This forum is an innovative strategy for promoting interdisciplinary discussion and care innovation for complex cases.