Quality of care in academic neurology departments

In striving to improve the quality of patient care, today's academic neurology department faces special problems. Factors that are inherent in the department's broader academic mission and in the organization of a major teaching hospital can compromise practice efficiency, reduce ease of access, and undermine cost competitiveness. However, the same environment also provides the opportunity to exploit areas of unique clinical expertise, create valued-added services, and develop regional approaches to service-line integration and disease management strategies. A major challenge for the academic department is to validate the quality and efficiency of its current services while assuming a leadership role in the development of new approaches to quality improvement. This challenge must be met without losing sight of the department's equally important parallel commitments to research and education.