Do Neurocritical Care Units Save Lives? Measuring The Impact of Specialized ICUs

Excerpt

A variety of organizational models have been used to deliver care to critically ill patients with neurologic disorders. Primary care may be provided by general intensivists, who often rely heavily on consultative support from neurosurgeons and neurologists. This approach is especially common in Australia, New Zealand, Canada and some European countries. Intensive care units (ICUs) organized in this fashion are usually “closed”, meaning that admissions and discharges are largely the responsibility of the attending intensivist. In this case, there are typically daily multidisciplinary rounds with a single team of clinicians. An alternative method is for primary care to be delivered by neurosurgeons or neurologists, in this case depending greatly on consultative input from various subspecialists. The corresponding ICUs are frequently “open”; that is, at any given time, there may be multiple attending physicians with patients admitted under their care, each of which, in turn, has numerous consultants involved. This approach has, historically, been the most common to be used in the United States. …