Sunnybrook Rapid Access in Neurosurgery (RAIN) Clinic

Sunnybrook’s Rapid Access in Neurosurgery (RAIN) Clinic is here to serve patients by expediting the evaluation and treatment process for individuals requiring neurosurgical care.

RAIN-eligible patients can be referred to Sunnybrook’s RAIN Clinic via three physician pathways:

1. CritiCall – Eligible neurosurgical patients presenting to external hospitals who are connected via CritiCall and the Sunnybrook neurosurgeon determines the patient would be appropriate for RAIN.
2. Sunnybrook Emergency Department (ED) – Eligible neurosurgical patients presenting to Sunnybrook’s ED.
3. External ED – External ED physicians who believe a patient would be appropriate for the RAIN clinic can submit a completed referral form.

Who is eligible for the RAIN Clinic?

Patients who, in the opinion of the referring physician, require an urgent assessment and opinion from a neurosurgeon within one to two weeks. Patients at significant risk of neurologic deterioration within 72 hours should still be triaged through emergency/CritiCall. Patients with longstanding neurosurgical concerns should be referred to a neurosurgeon through the usual mechanisms.

What investigations are necessary in order to refer to the RAIN Clinic?

• Brain tumour: recent CT head and/or MRI brain
• Traumatic Brain Injury: recent CT head and/or MRI brain
• Intracranial hemorrhage (traumatic or spontaneous): recent CT brain
• Hydrocephalus: recent MRI brain
• Spinal degenerative with neurological deficit (non-emergent): recent MRI spine
• Intradural spine/nerve tumour: recent MRI spine
• Any incidental vascular anomaly/aneurysm

What to expect after submitting a referral?

If the referral is not deemed to be appropriate for the RAIN clinic, a rejection letter will be sent to the referring physician. If the patient is accepted for clinic, a notification of the appointment will be sent to the patient, as well as the referring physician.

How to submit a referral?

Download and complete the Sunnybrook RAIN Clinic Referral Form, and fax to 416-480-5576 along with applicable imaging reports. If you have questions about the form, please contact RAINclinic@sunnybrook.ca