St George's University Hospitals NHS Foundation Trust, London, UK
St George's University Hospitals NHS Foundation Trust, London, UK.
Clin Med (Lond). 2019 Mar;19(2):119-126. doi: 10.7861/clinmedicine.19-2-119.
St George's Hospital hyperacute neurology service (HANS) is a comprehensive, consultant-delivered service set in a teaching hospital regional neuroscience centre. The service addresses deficiencies in acute neurological care previously highlighted by the Royal College of Physicians and the Association of British Neurologists. HANS adopts a disease-agnostic approach to acute neurology, prioritising the emergency department (ED) management of both stroke and stroke mimics alike alongside proactive daily support to the acute medical unit and acute medical take. Rapid access clinics provide a means to assess ambulatory patients, providing an outlet to reduce the burden of referral from primary care to acute medicine. This paper reports the results from the first year of the service. Admission was avoided in 25% of the cases reviewed in the ED. Compared to historic data, there was a significant improvement in the length of stay for non-stroke disorders while the occupancy of stroke beds by non-stroke cases reduced by 50%. The configuration of this service is replicable in other neuroscience centres and provides a framework to reduce the barriers facing patients who present with acute neurological symptoms.
圣乔治医院超急性神经科服务（HANS）是一个全面的、由顾问提供的服务，位于教学医院的区域神经科学中心。该服务解决了之前皇家内科医师学院和英国神经病学家协会强调的急性神经护理方面的不足。HANS 采用一种无疾病诊断的急性神经病学方法，优先考虑急诊部（ED）管理中风和中风模拟症，同时积极支持急性内科病房和急性内科接诊。快速通道诊所提供了一种评估门诊患者的方法，为减少从初级保健到急性医学的转诊负担提供了一种途径。本文报告了该服务的第一年的结果。在 ED 审查的病例中，有 25%的病例避免了入院。与历史数据相比，非中风疾病的住院时间显著缩短，而中风床位的非中风病例占用率降低了 50%。这种服务模式在其他神经科学中心具有可复制性，为那些出现急性神经症状的患者提供了一个减少障碍的框架。
