Neurosurgery Comanagement Service
|Quinn Cheng, MD
A new, more intensive model of perioperative medical care known as "comanagement" has grown in popularity. Driven largely by hospitalists, comanagement is a collaborative effort that lets the internist share the responsibility, authority, and accountability for care of the surgical patient. At UCSF, the Comanagement with Neurosurgery Service (CNS) manages acute and chronic medical problems in patients hospitalized on the adult Neurological Surgery Service. Going beyond the role of a traditional consultant, the CNS hospitalists form an integral and vital component of their care team.
CNS hospitalists screen all neurosurgery patients at the time of admission for conditions that increase the risk of medical complications. The hospitalists proactively round on these high-risk patients, and orders tests, treatments, and subspecialty consultation as needed to prevent complications, or address them at the earliest possible time. The CNS service also performs urgent preoperative medical evaluations and trouble-shoots medical problems. To ensure that these patients receive the highest quality and safest care, the CNS hospitalists communicate and coordinate their efforts with a multidisciplinary team of physicians, pharmacists, nurses, rehabilitation therapists, and case managers.
In addition to performing this clinical mission, CNS hospitalists collaborate with the neurosurgeons in research endeavors (Arch Intern Med, 2010), and education of Neurosurgery housestaff. and education. A UCSF hospitalist, Catherine Lau, also serves as the Department of Neurological Surgery's Director of Quality & Patient Safety.