Journal Article

A Randomized Trial of Nighttime Physician Staffing in an Intensive Care Unit

Cooney, Elizabeth, Halpern, Scott D, Schweickert, William D, Harhay, Michael O, Bakhru, Rita N, Fuchs, Barry D, Bellini, Lisa M, Mikkelsen, Mark E, Kerlin, Meeta Prasad, Gabler, Nicole B, Small, Dylan S, Hansen-Flaschen, John

2013

Overview

In this single-center, controlled trial at a U.S. academic medical center, investigators found that having in-house intensivists available at night did not have a significant effect on the length of stay in the ICU. Most studies suggest that intensivist physicians improve patient outcomes in intensive care units (ICUs). 1 – 3 It is thus tempting to conclude that a “dose–response effect” might exist, such that greater exposure to intensivists would be associated with even better outcomes. 4 Indeed, some authors argue that 24-hour presence of seasoned intensivists at the bedside of patients would improve diagnostic and therapeutic efficiency, particularly for high-risk patients. 5 – 7 As a result, many ICUs, including one third of academic ICUs in the United States 8 and nearly three quarters of ICUs in Europe, 9 , 10 use in-hospital intensivist staffing at night. Before-and-after studies of nighttime . . .

• Publisher: Massachusetts Medical Society
• Subject: Aged / Biological and medical sciences / Data processing / Evidence-based medicine / Female / General aspects / Health participants / Hospital Mortality / Hospitalists / Hospitalization / Hospitals / Hospitals, University / Humans / Intensive care / Intensive care units / Intensive Care Units - manpower / Kaplan-Meier Estimate / Length of Stay / Male / Medical sciences / Middle Aged / Mortality / Nighttime / Pennsylvania / Personnel Staffing and Scheduling / Physicians / Public health. Hygiene / Public health. Hygiene-occupational medicine / Sensitivity analysis