Neurology Rapid Access Clinic – Referral Pathway

This clinic has opened with the intent of diverting patients with Transient Ischaemic Attacks (TIAs) from hospital admission for investigation as an inpatient, and instead having them worked up in an expedited fashion as an outpatient. ED will now be able to clinically assess patients, organise appropriate initial investigations (including a CT/CTA) and then discharge them to be seen in the clinic, ideally within less than a week.

The protocolling of the CT/CTA scans is done by the NIISWA fellow in hours (Mon-Fri 8am to 5pm) on DECT 75784, and the radiology registrar out of hours on DECT 76815. The patients can then be referred to the clinic via eReferral.

Please see the attached pathway for information on patient selection criteria. Direct clinic referrals from ED should only be for clear TIAs, other undifferentiated neurological patients should continue as usual and be seen by the neurology registrar in ED – who may then self-refer to the NRAC for follow-up if appropriate.

Patients will need to go home with a NRAC information sheet – found on the flight deck near the SJA fax (see picture below). The neurology team may organise an outpatient MRI for some of these patients before their clinic appointment, so please alert patients to this possibility, and before the patient leaves ED make sure that you have asked the relevant questions needed to fill out the MRI safety questionnaire on the eReferral.

The full clinic model of care is also available here:

Dr James Wheeler
Dr James Wheeler

Emergency Physician, SCGH, WA, Australia

Articles: 498

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