News

8.22.2018

ARNPs Streamline Neurosurgery Screening and Assessment at UHealth Community Clinics

Specially trained advanced registered nurse practitioners are now evaluating people with neurologic concerns at UHealth clinics across South Florida. Expanding access to these specialty services is one goal, but the ARNPs also aim to speed up the time it takes for patients to be assessed and referred, when warranted, to a neurosurgeon or other health care provider.

Neurosurgery can be complex, but the process to get screened doesn’t have to be. That is what neurosurgery leaders at UHealth – the University of Miami Health System recognized when launching the new ARNP Clinic Program in April.

“The ARNP Clinic Program is off to a great start — these professionals are making a true difference. They are meeting with patients close to where they live and work, and doing an initial assessment for neurosurgery that can save time and money,” said Allan D. Levi, M.D., Ph.D., professor and chair of the Department of Neurological Surgery at the University of Miami Miller School of Medicine. “It’s really about extending our expertise on the main campus out into neighborhoods across South Florida.”

The ARNPs help ensure the appropriate candidates have access to a wide range of innovative diagnostic and treatment options. UHealth provides cranial services, functional neurosurgery procedures, cerebrovascular interventions, spine services and peripheral nerve therapies.

“We are a surgical practice that receives about 12,000 yearly referrals with a complex sub-specialty patient population, which are not all surgical,” said Jennifer Rodriguez, director of clinical programs in the Department of Neurological Surgery.

To simplify a somewhat lengthy intake process, the department now offers patients an appointment up front with a neurosurgical-experienced advanced nurse practitioner for further work-up, Rodriguez said.

Ashley Kuleba, M.S.N., ARNP, is a prime example. She sees patients with special neurologic concerns in Palm Beach and Broward counties.

“My practice focuses predominately on spine-related issues,” she said. “I most commonly see patients with various forms of stenosis, scoliosis, disk herniations and spinal cord tumors.”

Evaluating these patients in their communities eliminates the need for them “to travel all the way to the main campus,” she added, “a task often made more difficult by the inherent limitations imposed by their conditions.”

The initial assessment can include an order for advanced imaging, which for many patients helps inform a decision regarding surgery. It also works the other way around — the ARNP evaluation and imaging results sometimes rule out the need for neurosurgery.

“I have also directly helped patients with complications and chronic conditions that require other specialties get to the right place,” Kuleba said.

ARNP engagement with patients does not stop following referral or on the day of neurosurgery.

“We offer post-operative patients the ability to be assessed at any of our satellite clinics closer to their home,” Kuleba said. “Our satellite clinics are equipped to pro-vide a full range of post-operative outpatient services, including advanced imaging and physical therapy.” Follow-up care is individualized to meet the needs of each patient.

So far, the ARNP Clinic Program has been generating excellent reviews.

“The feedback has been positive from both our patients and referring physicians,” Rodriguez said.

“Everyone is excited about the opportunity to receive the full benefits of UM’s neurosurgery practice at a location far more convenient and closer to home,” said Kuleba. “Patients appreciate the option to see a nurse practitioner, whose schedule is often far more accessible than the surgeons’ schedules.

“It is a great opportunity to help people with significant and potentially life-altering neurological conditions,” she added. “It is also an honor and privilege to work alongside such brilliant and world-renowned neurosurgeons.”

UHealth ARNP Clinic locations include:

UHealth Tower – 1321 NW 14th St., Suite 306

The Lennar Medical Foundation Center – 5555 Ponce de Leon Blvd., Coral Gables

UHealth Deerfield – 1192 E Newport Center Dr. Suite 100, Deerfield Beach

UHealth Boca Raton – 3848 FAU Boulevard, Suite 305, Boca Raton

Sylvester Comprehensive Cancer Center – 1475 NW 12th Ave., 1st Floor

UHealth Kendall – 8932 SW 97th Ave., Kendall

UHealth Palm Beach Gardens – 3401 PGA Boulevard, Suite 400, Palm Beach Gardens

To refer patients to UHealth Neurosurgery, please visit, www.ummd.org or call UHealth Physician Partner Services at 305-243-UMMD (8663) or 800-844-UMMD (8663). UHealth Neurosurgery also has an online physician referral tool with the personal cell phone numbers, email addresses and treatment specialty areas for each physician on the team. To access, please visit https://bit.ly/2Ps6neo.

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