Neuro Critical Care consults in neuro IMC Workflow

 All neurology patients within the 4-IMC will remain on either CNS or Stroke (primary team) services. The primary team will handle all patient-related tasks to streamline workflow and reduce confusion among teams. 

The neuro-critical care (NCC) attending physician and APP will make daily consultative rounds in the IMC on G4 (only on G5 in rare situations determined by CNS and NCC attending). The primary team (CNS or Stroke) will place a formal consult order request for appropriate patients to NCC, listing specific questions/issues for consult.  There is a "consult to neurocritical care" order in EPIC - this will generate a Tiger message to consult team (If identified overnight, it would make sense to send order after 6:30 AM when the APP arrives for the day).

The NCC team will round with nursing in the IMC. starting at 8:00AM, to assess clinical patient issues, both active and resolved. The NCC team will "sign off" when the patient is deemed stable and the CNS/Stroke attending agrees that consultative input is no longer required.

Team communication is paramount to success! The NCC consult team APP will be stationed in the IMC. The CNS/Stroke teams will find the APP to touch base regarding consult recommendations after morning rounds (there will not be an expectation that a representative from the primary teams will meet/round with the consult team at a specific time).

A key workflow mandate is that orders will be written by the CNS/Stroke teams as the default workflow.  In the future, as we become more comfortable with the new workflow, emergent or specialized orders that the NCC team suggests and wants to place immediately, may be communicated via Tiger with primary team.

Family meetings will be held between the primary teams and families. If NCC input is needed to assist with the meeting, they will be invited to join.

For select consult requests i.e., chest pain, GI bleeding etc, organ system specific consult services such as cardiology or GI/surgery should be consulted at the discretion of the primary team attending and of course with input from NCC team.

 Last Updated: August 8, 2024