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Doctors aim for focused care at University Hospital's new Neurosciences Center

Wednesday, September 26, 2012 | 8:43 p.m. CDT; updated 10:41 p.m. CDT, Wednesday, September 26, 2012

COLUMBIA — Pradeep Sahota walks down the hall of the Missouri Neurosciences Center with a smile on his face. The work he and N. Scott Litofsky have put into getting the center started at University Hospital has finally paid off.

For Sahota, chairman of the MU School of Medicine's Department of Neurology, neurological sciences are more than just an occupation. Sahota’s father suffered a stroke when he was younger that left him paralyzed.

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“I couldn’t do a whole lot for my father,” Sahota, a neurologist, said. “We are able to do much better with the expertise and the technology we have here."

Although Sahota doesn't like to talk in detail about that experience, he brims with obvious pride when he talks about the new 18,119-square-foot neurosciences center on the seventh floor of University Hospital. Opened Aug. 1, it's the only center in mid-Missouri providing comprehensive care for neurology patients of all types in one place.

Boone Hospital Center offers a 26-bed general neurology nursing care unit and a six-bed neuroscience intensive care unit for its patients, along with a Neurodiagnostics Services area. But, these are not located on the same floor, as the units are on the fifth and the services area is on the first.

The Truman Veterans Hospital treats neurology patients but doesn't have any rooms specific to neurology care; patients are admitted to a general medical inpatient unit.

Before the comprehensive care center was created at University Hospital, neurology patients were on one floor and neurosurgery was on another, said Litofsky, chief of the division of neurosurgery. That meant brain specialists weren't all in one place.

Having clinical and surgical needs all on one floor has made the center’s staff aware of everything going on around the patient, resulting in greater awareness across the institution, Litofsky, a neurosurgeon, said. And that has improved the experience of patients, their families and caregivers.

The Missouri Neurosciences Center has a team of 16 neurologists and three neurosurgeons. Since the center opened, the neurosurgeons have performed about 100 neurosurgical procedures for brain aneurysms, trauma, brain tumors, spinal disorders and other illnesses. There are currently eight to 10 patients scheduled for future epilepsy-related surgeries, Sahota said.

The center includes 28 rooms, all equipped with “smart room” technology, which allows for the collection of a patient’s vital signs and heart rate. The information is automatically recorded in the patient’s electronic medical record, accessible to the appropriate caregivers. The rooms also utilize a bar code scanning system to ensure that a patient’s medication is given correctly and at the right time.

Four of the 28 rooms are for epilepsy patients. The rooms have automatic response systems — including video and audio recording devices, and electroencephalography, or EEG — that alert caregivers when a patient suffers a seizure. They're also equipped with an alert button if a patient or family member notices signs of a seizure that might not be apparent on video.

Monitoring epilepsy patients on video makes it easier for doctors to pinpoint the specific spot in the brain that is affected, go in and place electrodes where the epilepsy is located.

Aside from the technology, Sahota and Litofsky stressed that the center is striving to provide complete care of the patient and his or her family.

“It’s not the disease we treat, but the patient we treat,” Sahota said.

Improvements have been made to patient rooms to include televisions that provide games and movies in addition to educational materials to help families better understand what their loved one is going through. Other additions include shelving specifically for patients and their families as well as a recliner in case a family member needs to stay overnight.

Separate cabinets for nurses are accessible from the hallway, so nurses can cater to a patient’s needs without entering the room.

A significant number of the brain injuries the staff is likely to see are related to falls. Twenty percent to 30 percent of people who fall suffer moderate to severe injuries including head traumas, according to the Center for Disease Control and Prevention. In 2009, theCDC reported about 20,400 older adults – age 65 and older – died from unintentional fall injuries. The CDC also reports that falls are the leading cause of injury death and the most common cause of nonfatal injuries and hospital admissions for trauma for older adults.

Dixie Keener, 74, fell in early September. Her family had been unable to wake her the morning of Sept. 4, at her home in Linn, so they took her to Capital Region Medical Center in Jefferson City. But the doctors there told her they did not have the facilities to treat her. They suggested she go to University Hospital.

When Keener arrived at the hospital, she was told she'd suffered a subdural hematoma, bleeding on the surface of the brain and that she was going to be in the hospital for two weeks. She was transferred to the Missouri Neurosciences Center when physicians determined she wouldn't need surgery. There Keener received fresh frozen plasma to repair the bleeding part of her brain and reverse the negative effects of Coumadin, the blood thinner she had been taking that caused her brain to bleed easily after the injury.

She then worked with therapists to make sure she was able to eat and speak properly, two functions that were hindered by the bleeding.

Keener was discharged three days later on Sept. 7, and her family credits the constant monitoring and care she received.

“The facility deserves people’s praise,” said Stephen Keener, Dixie Keener’s son. “You can tell the people here are passionate about their jobs.”

It's been laborious but worth it, Litofsky said. “We’ve worked really hard, allowing us to move to the next level of patient care,” he said.

Sahota uses the words "dream come true" often when talking about the facility. “It’s beyond dreams, having something like this,” he said.


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