title: A multidisciplinary stroke clinic for outpatient care of veterans with cerebrovascular disease.
abstract: BACKGROUND
  Managing cerebrovascular risk factors is complex and difficult. The objective of this program evaluation was to assess the effectiveness of an outpatient Multidisciplinary Stroke Clinic model for the clinical management of veterans with cerebrovascular disease or cerebrovascular risk factors.
  
  
  METHODS
  The Multidisciplinary Stroke Clinic provided care to veterans with cerebrovascular disease during a one-half day clinic visit with interdisciplinary evaluations and feedback from nursing, health psychology, rehabilitation medicine, internal medicine, and neurology. We conducted a program evaluation of the clinic by assessing clinical care outcomes, patient satisfaction, provider satisfaction, and costs.
  
  
  RESULTS
  We evaluated the care and outcomes of the first consecutive 162 patients who were cared for in the clinic. Patients had as many as six clinic visits. Systolic and diastolic blood pressure decreased: 137.2 ± 22.0 mm Hg versus 128.6 ± 19.8 mm Hg, P = 0.007 and 77.9 ± 14.8 mm Hg versus 72.0 ± 10.2 mm Hg, P = 0.004, respectively as did low-density lipoprotein (LDL)-cholesterol (101.9 ± 23.1 mg/dL versus 80.6 ± 25.0 mg/dL, P = 0.001). All patients had at least one major change recommended in their care management. Both patients and providers reported high satisfaction levels with the clinic. Veterans with stroke who were cared for in the clinic had similar or lower costs than veterans with stroke who were cared for elsewhere.
  
  
  CONCLUSIONS
  A Multidisciplinary Stroke Clinic model provides incremental improvement in quality of care for complex patients with cerebrovascular disease at costs that are comparable to usual post-stroke care.
authors: Department of Veteran Affairs (VA) Health Services Research & Development (HSR&D) Center of Excellence on Implementing Evidence-Based Practice (CIEBP).
authors: Arlene A
authors: AA
authors: Schmid
authors: John R
authors: JR
authors: Kapoor
authors: Edward J
authors: EJ
authors: Miech
authors: Deborah
authors: D
authors: Kuehn
authors: Mary I
authors: MI
authors: Dallas
authors: Robert D
authors: RD
authors: Kerns
authors: Albert C
authors: AC
authors: Lo
authors: John
authors: J
authors: Concato
authors: Michael S
authors: MS
authors: Phipps
authors: Cody D
authors: CD
authors: Couch
authors: Eileen
authors: E
authors: Moran
authors: Linda S
authors: LS
authors: Williams
authors: Layne A
authors: LA
authors: Goble
authors: Dawn M
authors: DM
authors: Bravata
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