Rey Juan Carlos reinforces his multidisciplinary model in ALS

Five years after the King Juan Carlos University Hospital -public hospital Community of Madrid– launch a ALS and Neuromuscular Diseases Unitthe center has consolidated its care model based on multidisciplinarity and on an organizational premise: bringing together key assessments in a single day, facilitating the daily lives of people with high clinical complexity and, often, reduced mobility.

According to the center, the team coordinator, Dr. Ana Isabel Saldañaspecialist in the Neurology Service of the Mostoleño hospital and expert in neuromuscular pathology, summarizes: “We are facing very complex pathologies, with complications at many levels. In a monographic consultation you can help, but not as much as working as a team: each specialist contributes their part, you learn from others and that improves care. In addition, we cannot ignore the social context, which influences the patient’s decisions and ours.”

And the unit has specialists in Neurology, Pulmonology, Otorhinolaryngology, Endocrinology and Nutrition, Rehabilitation (motor and respiratory) and Speech Therapy, as well as a Palliative Care support team (doctor and psychologist from the LaCaixa foundation), as well as Social Work.

The work dynamic includes a weekly meeting to review the situation of patients already seen in the unit and plan the approach to the next ones. At King Juan Carlos, the unit’s activity is concentrated one day a week (Monday), with an average of two patients in that coordinated day.

The patient walks through the same morning eight or nine appointments between consultations and tests, at an approximate time of 9:00 a.m. to 12:30-1:00 p.m., with the aim of avoiding multiple visits on different days. After the day, the team jointly reviews the patient’s clinical situation and adjusts decisions and priorities (for example, interventions for swallowing problems, changes in respiratory support or psychological or palliative care supports).

At this time, the unit of Rey Juan Carlos University Hospital maintains 61 patients under follow-upof which 12 have ALS (amyotrophic lateral sclerosis, a degenerative muscle disease that affects motor neurons, causing muscle weakness, paralysis and difficulties speaking, swallowing or breathing).

Although the neuromuscular consultation at the Mostoleño hospital has a history of more than a decade, the multidisciplinary ALS unit model began to be configured in 2020 and was put into operation in 2021, progressively consolidating coordinated work between specialties. Recent milestones include inclusion in the regional network of ALS units, in development from 2025.

As for the unit’s immediate challenges, they focus on continuing improving quality of life and accompanying the patient throughout the disease, strengthening learning between specialists and participating in new therapeutic options as they become available.

The Rey Juan Carlos University Hospital provides health coverage to nearly 200,000 inhabitants of 18 municipalities (Móstoles, Navalcarnero, Cadalso de los Vidrios, San Martín de Valdeiglesias, Villa del Prado, Navas del Rey, Villaviciosa de Odón, Ceniientos, Rozas de Puerto Real, Pelayos de la Presa, Aldea del Fresno, Sevilla la Nueva, Villamanta, Villamantilla, Villanueva of Perales, Chapinería, Colmenar de Arroyo and El Álamo).

The Hospital has 339 single rooms, 18 doubles, 192 consultation rooms, 26 medical day hospital positions and 14 dialysis positions. In the surgical area it has 17 operating rooms, one for emergencies and one for cesarean sections, 6 dilation-delivery rooms, 32 examination rooms, 47 emergency rooms, 13 consultations and 2 video consultations, 10 treatment chairs, 21 radiology rooms, 10 neonatology positions and 18 ICU positions.