Vascular Neurology – Stroke Consults

Faculty contact:

Dr. Jamie Elliott

Vascular Neurology Schedule:

• Monday- Friday
• Pre-round on stroke consult patients, determine who needs to be seen each day
• Lead team responding to both emergency department and inpatient stroke codes
• Morning report
• Rounds
• Noon conference
• Clinical care activities or clinic in the afternoon
• As time permits: review patients on the stroke inpatient service, education for both services

Supervision:

The vascular neurology attending the stroke consult team.

Conferences

See Conferences

Expectations

• Review the chart for each stroke consult patient prior to rounds, determine which patients need to be seen each day.
• Lead the team responding to both emergency department and inpatient stroke codes. The fellow may need to be present for the stroke code immediately versus staffing and seeing the patient at a later time pending acuity and resident experience. Send a brief update to the attending regarding potential treatment patients ASAP.
• Lead rounds with the stroke consult team with involvement of the attending as appropriate. The attending is likely to be present earlier in the year; later in the year the fellow and attending may decide that the fellow can lead rounds independently.
• Review resident documentation and write a brief note or addendum on each patient evaluated with the stroke consult team.
• Staff all new stroke codes and inpatient consults with the residents. Ideally patients will be seen by the fellow as well during business hours. After staffing with the resident, the fellow should then update the attending and clarify any outstanding questions. Send a brief update to the attending regarding potential treatment patients ASAP.
• Check-in with the stroke consult team in the afternoon to follow-up on clinical plans from the morning and to determine who needs to be seen the next day.
• Teach residents and students as time permits.
• Pending clinical workload on the consult service, consider contributing to cases from the primary service in the afternoon.

Goals and Objectives:

Patient Care

• Goal: Fellow development of patient care skills sufficient for the safe and effective independent practice of vascular neurology
  • Objective: Rapid and appropriate triage, diagnosis, and management of acute stroke patients in a variety of clinical settings
    • Evaluation: Faculty evaluation of direct supervision of acute stroke care
  • Objective: Appropriate clinical care of neurological and medical issues in stroke patients after the acute phase to avoid complications and maximize recovery
    • Evaluation: Faculty evaluation of direct supervision of subacute stroke care
  • Objective: Appropriate clinical care of patients at elevated risk for stroke to lower that risk as appropriate
    • Evaluation: Faculty evaluation of direct supervision of stroke prevention

Medical Knowledge

• Goal: Fellow development of medical knowledge sufficient for the safe and effective independent practice of vascular neurology
  • Objective: Understanding of the science of vascular neurology sufficient for clinical care
    • Evaluation: Faculty evaluation of medical knowledge based on discussions during patient care

Practice-Based Learning and Improvement

• Goal: Fellow development of practice-based learning and improvement sufficient for the safe and effective independent practice of vascular neurology
  • Objective: Fellow case review with the multiple faculty to discuss merits of choices made and alternatives
    • Evaluation: Faculty and fellow evaluation of benefit of fellow case review
  • Objective: Effective evidence identification and appraisal for clinical questions
    • Evaluation: Faculty evaluation of this ability as questions arise during clinical care where the fellow is asked to find evidence, and after EBM discussions during journal club

Interpersonal and Communication Skills

• Goal: Fellow development of interpersonal and communication skills sufficient for the safe and effective independent practice of vascular neurology
  • Objective: Determination of the precise time of stroke symptom onset or time the stroke patient was last known well in patients with communication limitations
    • Evaluation: Faculty evaluation of direct supervision of acute stroke care
  • Objective: Effective discussion of end-of-life care options
    • Evaluation: Faculty evaluation of direct supervision of these discussions

Professionalism

• Goal: Fellow development of professionalism sufficient for the safe and effective independent practice of vascular neurology
  • Objective: The fellow will learn ethical, regulatory, and legal aspects of stroke care, including the difference between standard and investigational tests and treatments, and ethical and legal issues involved in end-of-life care
    • Evaluation: Faculty evaluation of direct supervision of these care issues

Systems-Based Practice

• Goal: Fellow development of systems-based practice sufficient for the safe and effective independent practice of vascular neurology
  • Objective: The fellow will demonstrate the ability to work in a multidisciplinary fashion with nurses, case managers, social workers, therapists, primary care physicians, and the various medical and surgical specialties involved in the care of stroke patients
    • Evaluation: Faculty evaluation of direct supervision of interactions with these groups
  • Objective: The fellow will learn how to triage patients and allocate resources such as inpatient beds, tests, and treatments to provide high quality, cost-effective care
    • Evaluation: Faculty evaluation of direct supervision of patient care
  • Objective: The fellow will become familiar with clinical practice guidelines and participate in the creation and review of stroke program policies and procedures relevant to patient care
    • Evaluation: Faculty evaluation of direct supervision of involvement in these activities

Evaluation Matrix:

Latest revision: 06/17/2025 Jamie Elliott, MD, PhD