Royal North Shore Hospital (RNSH) / TIA Clinic 2010-2013

In 2010 the Girgensohn Foundation entered into a partnership with the Department of Neurology at the RNSH, establishing a Rapid Access TIA (Transient Ischemic Attack) Clinic. This is an exciting and novel initiative in Australia. The TIA and Neurovascular Clinic is designed to offer rapid access to a neurology consult, neurovascular ultrasound, echocardiogram and brain MRI for patients with a neurovascular event like a minor stroke or transient ischemic attack. Patients are triaged in the Emergency Department, high risk TIA patients (those at risk of a subsequent stroke) are admitted to hospital, low risk patients are treated in an outpatient’s clinic. The assessment of high riks versus low risk is based on an alogorithm, formulated in international research.

The TIA Clinic, lead by Professor Martin Krause, enables patients to stay at home until all tests and assessments are provided in one day. Staffed with a Neurologist, a Clinical Nurse and a Stroke Fellow, the clinic is running twice a week ensuring patients can be seen in a timely manner, as the first few days are critical following a TIA. Other benefits are fewer patients’ admissions to a hospital, whilst waiting for the different tests.

The clinic commenced seeing patients in May 2011 and was officially opened on September 12 by the Hon. Minister Jillian Skinner MP, NSW Minister for Health.

By 2012 the clinic had expanded their collaboration with other hospital departments and now have increased access to vital MRI and ultrasound equipment. This has made a significant improvement to scheduling and timing of tests for patients. The clinic now receives referrals from other hospitals, in particular Manly and Mona Vale, who currently have very limited neurology cover. The clinic services are steadily growing, and it is important as many Neurologists on the North Shore have long waiting times for the private rooms.

The TIA Clinic saw 405 new TIA patients over the two financial years 11/12 and 12/13. Including TIA follow ups and stroke follw ups they treated 742 patients in total. Patient feedback has been very positive.

Bed days saved for TIA new referrals for this period is 1620 days (4 bed days saved/patient). The cost saving for the RNSH for TIA referrals over those two financial years is $889,380 (standard acute bed day cost = $549).

The TIA Clinic continues to deliver very good health services to their patients. In the financial year 2014/15 they had over 600 episodes of service and the hospital has now approved a permanent nurse practitioner to the clinic.