Implementing a Neurohospitalist Program Improves Stroke Care Metrics and Patient Satisfaction Scores

Abstract

Objective

Compare the differences in health outcomes and patient satisfaction between a neurohospitalist model of care and a community-based neurologists model at a single community-based teaching hospital among in-patients diagnosed with a cerebrovascular accident (CVA).

Methods

Data was collected from the Stamford Hospital’s electronic medical records system. An assessment of patient health outcomes and satisfaction scores was conducted, comparing both discrete and continuous variables between the two time periods. An omnibus P-value of 0.05 (P < 0.05) was considered statistically significant.

Results

The sample consisted of 341 patients between the two periods, pre-period n = 168 (49.3%) post-period n = 173 (50.7%). Door to lab and door to tPA times decreased significantly between pre- and post-periods (P = 0.003 and P = 0.002, respectively) as did the number of MRIs (P < 0.001). In addition, statistically significant increases were found between pre-period and post-period percentages, all increasing over time: stroke education (P < 0.001), discharged on anticoagulant medication (P < 0.001), and discharged on anti-thrombolytic medication (P = 0.019). Patient satisfaction scores demonstrated mean gain across both periods for five of six items. Two items “Doctor’s Concern of my Questions/Worries” and “Skill of Doctors” demonstrated statistical significance (P = 0.020 and P = 0.029, respectively).

Conclusions

The introduction of a neurohospitalist service at a community-based teaching hospital improved patient health outcomes on time to intervention, stroke education, discharge medications as well as patient satisfaction. Therefore, it may be beneficial for hospitals to implement a neurohospitalist model of care for their patients presenting with CVA.