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Neuroscience: Growing Beyond Stroke Care

By jfellows@healthleadersmedia.com  
   April 15, 2016

The hands-on work of the neuroscience patients led to wider hallways and exam rooms to accommodate electric wheelchairs and additional caregivers who accompany patients to appointments. Lighting and building acoustics were designed to accommodate patients, as well. No detail was left to chance. Picking out the right chairs for the waiting room took an entire day because patients reported that people who have spinal rods can't sit low and need additional support on the seat. "There are some really important things our patients told us that we would not have known," says Kerr. "We would have designed a standard office building with waiting room space."

Paint colors, carpet nap, and lighting were chosen with patients because of their firsthand experience, but it is the new "hallway conversations" and care coordination opportunities that clinicians are most excited about.

The center is meant to be a comprehensive outpatient center that reduces the number of appointments for neuroscience patients by using a team-based approach to care. "The only thing that was in one location before this center was our clinics," Kerr says. "We made our patients seek out our services, but we've flipped that model and now all of us circle the patients in one building."

The new center houses 21 neuroscience subspecialties, imaging, neuro-rehabilitation services, and physical and occupational therapies, which Longo says leads to more collaboration. "One situation we're commonly in is that a patient will have some features of a movement disorder, such as Parkinson's, and some features of a dementia, such as Alzheimer's, and we want to show this to a colleague," Longo says. "I can't describe the patient or tremor over the phone. In the old model, the patient would have to make a separate appointment and come back to our movement disorders clinic. Now I can walk over to one of our eight movement disorder neurologists and say, 'Hey, can you come and eyeball this patient?' Even if it's just for a minute, it's so much more efficient."

The new center, says Kerr, is poised to handle the growth of its neuroscience ambulatory visits, which has ranged from 15% to 20% per year since 2013 when its patient volume was 35,000 annually. Kerr says neuroscience is on the cusp of an innovation bell curve.

"We understand risk factors for cardiovascular disease, we've got lipids, we've got statins, but we don't understand Alzheimer's," says Kerr. "There is a partnership with our physician and neuro scientists at Stanford, and we eagerly anticipate many new discoveries and treatments."

Stanford's new center also connects patients to cutting-edge research. "When a patient has been affected with a neurological disorder that doesn't have an easy cure, having access to the research is so important, and a traditional clinic space is not built to support research activities for the patients, families, and physicians. We have space dedicated to make research access easy and efficient," says Longo, referring to the Alzheimer's Disease Research Center that is funded by the National Institutes of Health.

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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