Abstract
NICE TIA guidelines (2019) advise against performing CT unless there is suspicion of a relevant alternative diagnosis, instead recommending TIA clinic assessment to consider MRI (which should be on the same day as the assessment). This may be challenging in some trusts due to limited access to MRI. In a university teaching hospital, dedicated MRI slots for TIA clinic use were introduced to improve access to same-day scanning. This audit aimed to assess the timing of neuroimaging in TIA clinic, before and after the introduction of the dedicated MRI slots. Methods: We conducted a retrospective audit of patients seen in TIA clinic. Data were collected from the hospital computer system, and analysed using Microsoft Excel. In September 2020 two same-day MRI slots per TIA clinic were introduced. Taking into account COVID-19 disruption, data were collected from a 3-month period prior to, and a 3-month period after, this intervention (Sept-Nov 2019 vs. Oct-Dec 2020). We recorded the number of MRIs performed and the time from scan request to completion. Results: N=354 patients included (170 in initial period vs. 184 in second period), of whom 138 had MRI. Prior to the introduction of the dedicated MRI slots, 0% of MRIs occurred on the same day, 3.4% at 1-3 days, 10.3% 4-7 days, 29.3% at 1-4 weeks, and 56.9% >4 weeks. After the intervention, 38.8.7% of MRI scans occurred on the same day, 13.8% at 1-3 days, 15% at 4-7 days, 22.5% at 1-4 weeks and 10% at >4 weeks. Conclusions: The introduction of dedicated MRI slots for TIA clinic improved access to same-day MRI, but overall access remained suboptimal. Protected slots may help improve access, but current neuroimaging is still not in keeping with NICE guidance. Further research should identify reasons for delayed access to MRI to facilitate further service improvements.