Dr. Joshua Medow is Assistant Professor of Neurological Surgery and Biomedical Engineering and is our Director of Neurocritical Care at the University of Wisconsin Hospital in Madison. Dr. Medow founded the neurocritical care program in 2008. The footprint is a state of the art, 16-bed, dedicated neurocritical care unit with multimodality monitoring for each patient room. The clinical focus is on providing value in the care of neurologically ill patients by improving outcomes and reducing costs. Following best practices and identifying quality improvement initiatives in our ICU reduced mortality in the sickest patients by 43% and costs by about $3 million.
Unit members attend a daily journal club where a single article is presented by a team member (nurse, pharmacist, dietician, social worker, therapist, physician). This cross discipline training method allows the team to learn about the issues and constraints of practices different from their own. This strengthens the team's approach to patient care and allows the unit to focus on issues from multiple different perspectives.
The unit also has a weekly hands on lab for interdisciplinary education. The focusses are on nutrition, advanced directives, EEG interpretation, and ventilator management. During these conferences, participants get to experiment with various clinical scenarios and possible treatment options. This means that participants get connected to equipment to measure their own metabolic rate, cerebral electrical activity, and ventilation. With the ventilation experiments they learn the different modes and settings by both feeling what it does to them and also visually when the ventilator is connected to a pig lung. This hands-on approach reinforces learning the "how and why" of human physiology and pathophysiology.
Neurocritical care is a team effort. Each of the disciplines from the different representative specialties are integrated providing for interdisciplinary, patient centered care. Because of this approach, each discipline's ideas matter equally and consequently problems and solutions are rapidly identified and acted upon. UW Health and particularly our team members are proud of the level of care provided in our neurocritical care unit and the patients and families affirm their support of this program.