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Review
. 2018 Apr-Jun;14(2):134-140.
doi: 10.14797/mdcj-14-2-134.

Is 24/7 In-House Intensivist Staffing Necessary in the Intensive Care Unit?

Faisal Masud  1 , Tina Yaqing Cai Lam  2 , Sahar Fatima  1
Affiliations
Review

Is 24/7 In-House Intensivist Staffing Necessary in the Intensive Care Unit?

Faisal Masud et al. Methodist Debakey Cardiovasc J. 2018 Apr-Jun.

Abstract

Over the past few decades, an increasing number of studies have shown that intensivist-staffed intensive care units (ICUs) lead to overall economic benefits and improved patient outcomes, including shorter length of stay and lower rates of complications and mortality. This body of evidence has convinced advocacy groups to adopt this staffing model as a standard of care in the ICU so that more hospitals are offering around-the-clock intensivist coverage. Even so, opponents have pointed to high ICU staffing costs and a shortage of physicians trained in critical care as barriers to implementing this model. While these arguments may hold true in low-acuity, low-volume ICUs, evidence has shown that in high-acuity, high-volume centers such as teaching hospitals and tertiary care centers, the benefits outweigh the costs. This article explores the history of intensivists and critical care, the arguments for 24/7 ICU staffing, and outcomes in various ICU settings but is not intended to be a comprehensive review of all controversies surrounding continuous ICU staffing.

Keywords: 24/7 staffing; ICU; advanced practice provider; critical care unit; intensive care unit; intensivist.

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Conflict of interest statement

Conflict of Interest Disclosure: Dr. Masud is a consultant for Mallinckrodt Pharmaceuticals and Chiesi USA, Inc.

Figures

Figure 1.
Figure 1.
Timeline of the development of intensivists.
Figure 2.
Figure 2.
Changes in hospital and ICU beds from 1985 to 2010.
Figure 3.
Figure 3.
Projected supply versus optimal utilization for intensivists, 2000–2020. FTEs: full-time equivalent physicians
See this image and copyright information in PMC

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