Abstract WP094: A Practical Urgent Transient Ischemic Attack Clinic Model with Proven Impact

Background: Transitions of care represent a period of high vulnerability for patients with vascular neurological conditions, where adverse events and readmissions are common. Up to 20% of patients experience complications within two weeks of discharge, many preventable with structured follow-up. Balancing safety, access, and resources is especially relevant in the care of transient ischemic attack (TIA), where admission has traditionally expedited diagnostic evaluation and secondary prevention. An urgent TIA clinic offers a systems-based solution to reduce admissions while maintaining standards of care, timely diagnostics, and patient safety. Methods: In January 2024, we developed and implemented an urgent TIA clinic pathway for patients presenting with suspected TIA, regardless of their ABCD2 score. Data from January to July 2025 were analyzed. Participants were eligible if they met the following criteria: vessel imaging in the emergency department (ED) showing no significant stenosis or large-/medium-vessel occlusion, ability to return within 5 business days for transthoracic echocardiogram (TTE) and brain MRI, and ability to follow-up in urgent TIA clinic within 10 business days. Eligible patients were prescribed 21 days of dual antiplatelet therapy (DAPT) and high-intensity statin. The primary outcome was 30-day readmission, with 90-day readmission as the secondary outcome. Results: Forty patients (mean age 69.8 years, 52.5% female) met criteria. The mean ABCD2 score was 3.0 (range: 1–6). No patients were readmitted within 30 days. Similarly, no readmissions occurred within 90 days (29 patients). Conclusion: An outpatient urgent TIA clinic, using rapid imaging, structured follow-up, and early initiation of antithrombotic and statin therapy, provided a safe, practical, and scalable alternative to hospitalization. This model is particularly applicable to high-volume health systems seeking efficient, patient-centered TIA care. Our findings align with broader systems-based strategies to improve neurologic transitions of care, reduce unnecessary hospital utilization, and strengthen continuity of care between the ED and outpatient neurology.