The Division of Anesthesiology Critical Care Medicine in the Department of Anesthesiology strives to provide excellent care for its patients, embody professionalism, promote innovative educational programs for fellows, residents, medical students, the critical care team and the community, and engage in scholarly activities to improve patient outcomes while optimizing resource utilization.
The Division provides critical care services in the burn ICU, cardiovascular ICU, neurointensive care unit, and surgical ICU at Vanderbilt University Medical Center and in the surgical ICU at the Veteran’s Administration Medical Center, Nashville, TN. To address growing demands of critical care services across the institution, the Division has expanded to include 25 anesthesiology intensivists along with more than 35 acute care nurse practitioners (ACNPs) and physician assistants (PAs), making it one of the largest anesthesiology critical care medicine divisions in the country. The Division faculty also includes eight neurointensivists certified by the United Council for Neurologic Subspecialties. The Division operates using a multidisciplinary, intensivist-led critical care team model that includes fellows, residents, ACNPs, and PAs. Members of the Division routinely participate in CME activities and workshops to maintain and acquire new skills to keep abreast of modern technology and the changing spectrum of caring for the critically ill. This includes proficiency in ultrasound, echocardiography, and management of patients with ventricular-assist devices or who are on ECMO.
The Division supports the Anesthesiology Critical Care Medicine fellowship, which is an ACGME accredited one-year program providing an unparalleled innovative and in-depth critical care training opportunity. The fellowship is designed to meet the individual needs of each fellow in preparation for board certification and evidence-based critical care practice. Fellows have the option to pursue a second clinical or research fellowship if that aligns with their clinical or academic interests. The Critical Care Fellowship has recently been expanded to eight ACGME-accredited fellowship positions per year, accepting fellows with both anesthesiology and surgical training, and the fellowship has received accreditation for five years. Fellows have a diverse clinical experience through our subspecialty ICUs and our innovative didactic program of lectures delivered by multispecialty faculty, problem-based learning discussions, simulations, workshops, journal clubs, and an interactive web-based learning portal. Fellows also participate in teaching Fundamentals in Critical Care Support (FCCS) and the Advanced Trauma Life Support (ATLS) courses and in resident and medical student critical care lectures and simulation training.
Division faculty are involved in the training and mentoring of critical care fellows and residents from many disciplines, and also participate in educational activities at the local, regional, national, and international level. Faculty members from the Division are active leaders at Vanderbilt University Medical Center, including positions as Chief of Staff, Chairs of Sedation and Vascular Access Committee, Executive Medical Director for Critical Care, and Medical Directors of the burn ICU, cardiovascular ICU, and neurointensive care unit. In addition, Division faculty fill many leadership roles in the School of Medicine through the development of Immersion courses, the Research clerkship, and the Critical Care Skill programs as part of the redesigned medical school curriculum. An ongoing alliance between the Critical Care Division and the School of Nursing also supports an ACNP Intensivist training program. Division faculty also direct the BH Robbins Scholars program that provides a comprehensive, mentored research experience spanning anesthesia residency and an academic fellowship.
By encouraging research to identify better ways to care for perioperative and critically ill patients, the Division takes a proactive approach to the ever-changing demands and regulations in healthcare and the changing milieu of critical care. Active research programs in the Division of Anesthesiology Critical Care Medicine encompass both clinical and translational research and focus on perioperative risk factors and mechanisms of cognitive impairment, kidney injury in cardiac and non-cardiac patients, sepsis and its monitoring, education and implementation science, health resource utilization, multisensory training, and quality improvement projects involving among others remote bedside monitoring, use of rapid response teams and optimal consultation of a palliative care team. Active grants in the division include an R01, a K23 training grant, a R03 grant, and a FAER Education grant, in addition to numerous industry and Vanderbilt Institute for Clinical and Translational Research (VICTR) grants. Faculty have been involved in more than 20 peer reviewed manuscripts and textbook chapters in the past academic year alone in addition to abstracts and scientific presentations.