Intensivist staffing

Intensivist staffing patterns and hospital mortality following critical care unit admission: a systematic review

What was this review about?

Many professional organisations in critical care recommend that intensive care specialists (intensivists) should be primarily responsible for the medical care of critically ill patients, ideally via 24-hour in-hospital coverage. However multiple factors make this a difficult standard to achieve. 

This review looked at observational studies and randomised trials that compared the effect of alternative models of intensivist staffing on mortality for adult patients admitted to a critical care unit. 

What did the review find? 

The review identified 52 eligible studies involving 331,222 patients. All the eligible studies were observational; there were no randomised trials.

High-intensity staffing was associated with reduced mortality in the critical care unit and in hospital.

Within a high-intensity model, 24-hour in-hospital intensivist coverage did not reduce critical care unit or hospital mortality. 

The authors recommended that further research should determine which features of high-intensity intensivist staffing are associated with patient benefit and whether these can be replicated without the presence of intensivists.

Publication

  • Authors: Wilcox ME, Chong CA, Niven DJ, Rubenfeld GD, Rowan KM, Wunsch H, Fan E Title: Do intensivist staffing patterns influence hospital mortality following ICU admission? A systematic review and meta-analyses Publication: Critical Care Medicine Journal website PubMed citation