Multidisciplinary Rounds in the Neuro ICU

Core Structure and Implementation

The American College of Critical Care Medicine recommends implementing multidisciplinary rounds as a routine, structured practice in the Neuro ICU to improve communication, reduce errors, enhance family satisfaction, and optimize patient outcomes through coordinated care delivery 1

The Neurocritical Care Society, European Society of Intensive Care Medicine, and Society for Critical Care Medicine emphasize that a multidisciplinary team approach, including neurologists, neurosurgeons, pharmacists, and social workers, is fundamental to neurocritical care delivery 2
The team should include intensivists, neurologists, and neurosurgeons, as recommended by the European Society of Intensive Care Medicine 2, 3

The Critical Care Medicine guidelines recommend offering family members the option to participate in interdisciplinary team rounds to improve satisfaction with communication and increase family engagement, as suggested by the Society of Critical Care Medicine 1, 4
Interdisciplinary family conferences are associated with increased family satisfaction with communication and trust in clinicians, while reducing conflict between clinicians and family members, according to the American College of Critical Care Medicine 6

No directly cited facts are available for clinical outcomes, however, the importance of a multidisciplinary team is emphasized throughout the article

The European Society of Intensive Care Medicine recommends addressing the unique monitoring needs of neurocritical patients, including neurological examination status using Glasgow Coma Scale, multimodality monitoring data, and hemodynamic parameters 2, 8
The use of validated scales, such as RASS, SAS, BPS, or CCPOT, for sedation and pain assessment is recommended by the Neurocritical Care Society 7

Each patient discussion should systematically address current neurological status and trends, secondary brain injury prevention strategies, specific monitoring thresholds and interventions, early mobilization protocols, and family communication needs, as suggested by the Society of Critical Care Medicine 1, 6, 7

The European Society of Intensive Care Medicine recommends ensuring all monitoring data is readily accessible and displayed, using standardized documentation templates, and reviewing trends rather than isolated values to avoid poor information retrieval and documentation 5, 7
The American College of Critical Care Medicine suggests establishing protected time for rounds, silencing non-urgent pages during rounds, and using a structured format to maintain focus to mitigate interruptions and long rounding times 1
The Neurocritical Care Society emphasizes the importance of explicitly soliciting input from all team members, defining clear roles for each discipline, and ensuring nursing staff present patient data and participate in plan generation to prevent allied healthcare providers from feeling undervalued 3, 7
The European Society of Intensive Care Medicine recommends systematically reviewing all monitoring modalities, discussing how monitoring data influences treatment decisions, and recognizing that no monitor alone changes outcomes to avoid failure to integrate multimodality monitoring data into decision-making 2, 5, 8