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Leading the advance in neuroscience

Main Line Health July 16, 2018 By Andrew Norton, MD, FACP, Michelle J. Smith, MD, FAANS, Thomas Graham, MD, FAAN, and Joan Gibson, MSN, RN, NE-BC

Historically as physicians, we have organized our thinking in the context of our own practices. We’ve always tried to provide the best care we could, but now, as the health care landscape—knowledge, technology and patient interests—continues to evolve, we’re experiencing a sea change in how we approach our work. Health care is shifting from physician-centric to patient-centric, and the focus is on delivering the most comprehensive and coordinated patient care possible.

Responding to this re-direction, an increasing number of health systems—including Main Line Health—are adopting a service line structure. Interconnected, multidisciplinary areas are now spanning the care continuum and all sites of care (physician office, outpatient, inpatient, home, post-acute). The advantages are tremendous. Service lines allow us to operate through a strategic, programmatic lens to enhance capabilities, create economies of scale, and improve patient access.

In May 2017, Main Line Health officially introduced our neuroscience service line, led by Co-Medical Directors Michelle J. Smith, MD, FAANS, system chief of neurosurgery at Main Line Health and associate professor of neurosurgery at Jefferson, and Thomas H. Graham, MD, FAAN, system chief of neurology, Main Line Health, along with Joan Gibson, MSN, RN, NE-BC, system director of neuroscience and director of nursing at Bryn Mawr Hospital. Serving as lead executive is Andrew J. Norton, MD, FACP, Main Line Health senior vice president and chief medical officer.

The team is responsible for streamlining our delivery of all care related to the nervous system—across Lankenau Medical Center, Bryn Mawr, Paoli and Riddle hospitals as well as Bryn Mawr Rehab Hospital—and developing advanced processes and clinical protocols that will heighten our ability to diagnose and treat neurological disorders.

The link between all of the physicians within the neuroscience service line makes certain that our patients have access to the full complement of neurosurgery and intervention services offered across Main Line Health and at Jeff.

Our neuroscience capabilities, including complex trauma and spine surgery, were already far beyond those available at other community hospitals, and we are now in a position to expand the delivery of cutting-edge neuroscience proficiency across all of Main Line Health.

This new service line further solidifies our relationship with The Vickie and Jack Farber Institute of Neuroscience at Jefferson, led by Robert Rosenwasser, MD, MBA, FACS, chair of neurosurgery at Jefferson.

It was more than five years ago that we first established our partnership with Jeff, long considered a regional and national leader in neuroscience. This strategic planning and clinical collaboration includes:

  • An advanced neurovascular interventional program (including the western suburbs’ only neurointerventional lab at Bryn Mawr Hospital)
  • Facilitated consultation for complex cases
  • Access to clinical trials and novel treatments

The collaboration also ensures that Main Line Health is staffed with highly experienced neurosurgeons to support our facilities, including our trauma centers at Paoli Hospital and Lankenau Medical Center.

Today, even the most complex of cases can often be managed within the Main Line Health system. Dr. Smith, a Jefferson physician who practices on-site at Main Line Health on a full-time basis, is among an elite group of neurosurgeons who perform intracranial, endovascular, catheter-based thombectomy procedures (removing clots from vessels inside the brain), the most advanced interventions for acute ischemic stroke and the new gold standard of care. With time of the essence, our patients can receive this life-saving stroke treatment without needing to be transferred downtown.

The link between all of the physicians within the neuroscience service line makes certain that our patients have access to the full complement of neurosurgery and intervention services offered across Main Line Health and at Jeff. If there is a need to send a patient downtown to Jeff for specific services, we coordinate those visits and work together as a team in the patient’s continuum of care. Patients can also easily transition between Main Line Health specialists in neurology, neurosurgery, comprehensive neurovascular care, and neuro-rehabilitation—an essential offering as many conditions require the involvement of multiple experts.

With all of our neuroscience physicians under one umbrella, Main Line Health can readily schedule appointments with the appropriate specialists, preventing longer wait times and providing the best care possible.

For instance, planning has already started so that areas such as multiple sclerosis and dementia, for example, might no longer be defined by an individual practice or practitioner but by a system of practitioners with access to our considerable geographical breadth and resources. In this fashion, we can tap the exceptional talent of the entirety of health care professionals across Main Line Health.

In addition, the service line structure enables general neurologists to focus on specific areas of interest, if they choose.

In establishing the neuroscience service line, Main Line Health is:

  • Providing a structure for innovation
  • Leveraging best practices to improve clinical quality
  • Ensuring a consistent patient experience across campuses
  • Establishing a framework to communicate the scope of our capabilities

All are critical in ensuring that we are market-competitive and able to deliver the best possible outcome for every patient we serve.

Andrew J. Norton, MD, FACP, is senior vice president and chief medical officer, Main Line Health, and lead executive, neuroscience service line. Michelle J. Smith, MD, FAANS, is system chief of neurosurgery, Main Line Health; co-medical director, neuroscience service line, and associate professor of neurosurgery at Jefferson. Thomas H. Graham, MD, FAAN, is system chief of neurology, Main Line Health, and co-medical director, neuroscience service line. Joan Gibson, MSN, RN, NE-BC, is director of nursing, Bryn Mawr Hospital, and system director, neuroscience service line.