Neurology care comes to southeast Edmonton
The neurology clinic at the Covenant Community Health Centre provides timely assessments and continuity care for patients experiencing neurological conditions. Located in the outpatient department at the health centre, the clinic helps people move forward with treatment and get back to their lives.
Two clinics, two purposes
The neurology clinic at the Covenant Community Health Centre is actually two clinics operating under one roof. The first is the urgent neurology clinic, which sees patients who have a sudden or severe condition affecting the brain, spinal cord or nerves and need an assessment from a neurologist within four to six weeks. The second is a resident-run continuity clinic where patients receive ongoing care for conditions like Parkinson's disease, seizure disorders and migraines.
Getting patients seen quickly
The urgent neurology clinic focuses on patients with new-onset neurological concerns that need prompt attention but don't require hospital admission. Most referrals come from emergency departments, where doctors have already consulted with the on-call neurologist about the patient's case.
"Probably 90 to 95 percent of our patients in the urgent neurology clinic were seen in emergency or referred through RAPPID," says Theresa Griffin-Stead, who has worked with Covenant Health for 33 years and directly with stroke and neurology services since 2011.
RAPPID, which stands for referral, access, advice, placement, information and destination, is an Alberta Health Services call centre that serves as a single point of contact for care providers. When an emergency physician needs to consult with a specialist, they call the RAPPID line and get connected to the neurologist on call.
"It's usually for the more urgent patients that the doctor's going to call RAPPID because they need recommendations for tests," says Theresa.
The urgent neurology clinic operates as a one-time consultation service. Patients are assessed, receive recommendations for testing and treatment and are then referred back to their family physician or to other outpatient neurology clinics if they need ongoing care.
Seizures top the list
New-onset seizures make up the bulk of the urgent neurology clinic's caseload.
"Probably 70 per cent of our referrals are new-onset seizures," says Theresa.
These patients need to be seen quickly because a seizure diagnosis affects daily life in immediate ways. In Alberta, people who have had a seizure cannot drive for several months. They need testing, a proper diagnosis and guidance on what comes next, says Theresa.
In addition to patients who have had seizures, the urgent neurology clinic sees patients with new-onset tremors and other neurological symptoms that require specialist evaluation.
Younger than you might think
Contrary to what many people assume, the urgent neurology clinic's patients skew younger rather than older.
"We only see adults, but the majority of our patients are actually younger," says Theresa. "Especially the seizure patients, who are mostly 25 to 30 — in that age group."
While older patients certainly come through the clinic, Theresa notes that most of the patients in her current work queue are under 50.
A lean operation
The clinic runs with a small team. Theresa handles the scheduling, orders tests and co-ordinates care. Five neurologists rotate through the clinic, all of whom are part of the Grey Nuns Community Hospital neurology call roster. The stroke neurologists from the hospital also cover the urgent neurology clinic part time, with the exception of one neurologist who focuses solely on urgent neurology cases.
The clinic doesn’t have a dedicated registered nurse but is supported by staff assigned through the outpatient department at the community health centre. "It could be any of the licensed practical nurses or registered nurses, whoever is working that day," Theresa says.
More capacity in the new space
When the urgent neurology clinic was at the Grey Nuns Community Hospital, it could only operate on Fridays due to space constraints. The move to the Covenant Community Health Centre changed that.
"Since we've moved over, we’ve been able to run our urgent neurology clinic on Thursdays and Fridays," says Theresa.
A typical clinic day sees 13 to 15 patients. Adding a second day means the clinic can see roughly twice as many patients each week, reducing wait times and getting people the answers they need faster.
A welcoming environment
The new facility offers a different experience for patients compared to a hospital setting.
"To come here as a patient is not as intimidating as going into a hospital," says Theresa. "Patients can do everything here. It's like a one-stop shop."
Patients who need blood work, diagnostic imaging or other services can access them in the same building. And the modern, purpose-built space simply feels different.
"It's new. It's shiny. It's a nice building," Theresa says. "There's lots of space for the physicians and for the patients."
What the clinic doesn't do
The urgent neurology clinic has clear criteria for the patients it can help. It doesn't provide second opinions for patients already being followed by another neurologist. And it doesn't see patients with chronic neurological problems, established multiple sclerosis, concussions or chronic headaches or people who are 65 or older and have dementia.
Patients who have had a definite stroke or mini-stroke are directed to established stroke prevention clinics. The urgent neurology clinic also doesn’t accept referrals from Workers’ Compensation Board cases.
These boundaries help ensure the clinic can focus on what it does best: providing timely assessments for patients with new, urgent neurological concerns who need specialist input to guide their care.
Continuity for those who need it
For patients who do need ongoing neurological care, the resident-run continuity clinic provides that support.
These are typically people who are treated as inpatients during a hospital stay and then are transferred to the clinic for follow-up, says Theresa.
These patients are usually seen every three months for conditions that require ongoing monitoring and management, such as Parkinson's disease, seizure disorders and migraines.
Part of integrated care
The urgent neurology clinic and continuity clinic are some of several outpatient services that have relocated from the Grey Nuns Community Hospital to the Covenant Community Health Centre. Being part of this integrated health campus means patients can access multiple services without travelling across the city.
The move also frees up space at the hospital for services that truly need a hospital environment while providing neurological care in a community setting that feels more accessible and less clinical.
For both patients dealing with the uncertainty of new neurological symptoms and those needing ongoing monitoring and follow-up, the neurology clinic offers a path to treatment in a setting designed around their comfort and convenience.
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