The association between daytime intensivist physician staffing and mortality in the context of other ICU organizational practices: A multicenter cohort study

Critical Care Medicine

Volumn 43, Issue 11, 2015, Pages 2275-2282

  Costa, Deena Kelly ^a   Wallace, David J ^b   Kahn, Jeremy M ^b,c  

^a UNIVERSITY OF MICHIGAN   (United States)

^b UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^c UNIVERSITY OF PITTSBURGH GRADUATE SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

Intensive care unit organization; mortality; protocols; rounds; staffing

Indexed keywords

ADOLESCENT; ADULT; APACHE; ARTICLE; ARTIFICIAL VENTILATION; COHORT ANALYSIS; CONTROLLED STUDY; FEMALE; HOSPITAL ADMISSION; HUMAN; INTENSIVE CARE; INTENSIVE CARE UNIT; INTENSIVIST; MAJOR CLINICAL STUDY; MALE; MEDICAL INFORMATION SYSTEM; MEDICAL PRACTICE; MORTALITY; NURSE; PHARMACIST; PHYSICIAN; PRIORITY JOURNAL; RESPIRATORY THERAPIST; RETROSPECTIVE STUDY; AGED; CLINICAL TRIAL; COMPARATIVE STUDY; CONFIDENCE INTERVAL; CRITICAL ILLNESS; EVALUATION STUDY; GLASGOW COMA SCALE; HOSPITAL MORTALITY; MANPOWER; MIDDLE AGED; MULTICENTER STUDY; ODDS RATIO; ORGANIZATION; ORGANIZATION AND MANAGEMENT; OUTCOME ASSESSMENT; PERSONNEL MANAGEMENT; RISK ASSESSMENT; TIME FACTOR; TRENDS; UNITED STATES; YOUNG ADULT;

ADULT; AGED; APACHE; COHORT STUDIES; CONFIDENCE INTERVALS; CRITICAL CARE; CRITICAL ILLNESS; FEMALE; GLASGOW COMA SCALE; HOSPITAL MORTALITY; HUMANS; INTENSIVE CARE UNITS; MALE; MIDDLE AGED; ODDS RATIO; ORGANIZATIONAL INNOVATION; OUTCOME ASSESSMENT (HEALTH CARE); PERSONNEL STAFFING AND SCHEDULING; RETROSPECTIVE STUDIES; RISK ASSESSMENT; TIME FACTORS; UNITED STATES; YOUNG ADULT;

EID: 84944454153     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0000000000001259     Document Type: Article

References (26)

1. Pronovost PJ, Angus DC, Dorman T, et al: Physician staffng patterns and clinical outcomes in critically ill patients: A systematic review. JAMA 2002; 288:2151-2162
2. Halpern NA, Pastores SM, Oropello JM, et al: Critical care medicine in the United States: Addressing the intensivist shortage and image of the specialty. Crit Care Med 2013; 41:2754-2761
3. Angus DC, Kelley MA, Schmitz RJ, et al; Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS): Caring for the critically ill patient. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: Can we meet the requirements of an aging population? JAMA 2000; 284:2762-2770
4. Moran J, Scanlon D: Slow progress on meeting hospital safety standards: Learning from the Leapfrog Group's efforts. Health Aff (Millwood) 2013; 32:27-35
5. Checkley W, Martin GS, Brown SM, et al; United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study Investigators: Structure, process, and annual ICU mortality across 69 centers: United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study. Crit Care Med 2014; 42:344-356
6. Yoo EJ, Edwards JD, Dean ML, et al: Multidisciplinary critical care and intensivist staffng: Results of a statewide survey and association with mortality. J Intensive Care Med 2014 May 12. [Epub ahead of print]
7. Levy MM, Rapoport J, Lemeshow S, et al: Association between critical care physician management and patient mortality in the intensive care unit. Ann Intern Med 2008; 148:801-809
8. Kahn JM, Rubenfeld GD: The myth of the workforce crisis. Why the United States does not need more intensivist physicians. Am J Respir Crit Care Med 2015; 191:128-134
9. Kim MM, Barnato AE, Angus DC, et al: The effect of multidisciplinary care teams on intensive care unit mortality. Arch Intern Med 2010; 170:369-376
10. Ely EW, Baker AM, Dunagan DP, et al: Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med 1996; 335:1864-1869
11. Kollef MH, Shapiro SD, Silver P, et al: A randomized, controlled trial of protocol-directed versus physician-directed weaning from mechanical ventilation. Crit Care Med 1997; 25:567-574
12. Zimmerman JE, Kramer AA, McNair DS, et al: Acute Physiology and Chronic Health Evaluation (APACHE) IV: Hospital mortality assessment for today's critically ill patients. Crit Care Med 2006; 34:1297-1310
13. Wallace DJ, Angus DC, Barnato AE, et al: Nighttime intensivist staffing and mortality among critically ill patients. N Engl J Med 2012; 366:2093-2101
14. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med 2000; 342:1301-1308
15. Kahn JM, Goss CH, Heagerty PJ, et al: Hospital volume and the outcomes of mechanical ventilation. N Engl J Med 2006; 355:41-50
16. Lott JP, Iwashyna TJ, Christie JD, et al: Critical illness outcomes in specialty versus general intensive care units. Am J Respir Crit Care Med 2009; 179:676-683
17. Zeger SL, Liang KY: Longitudinal data analysis for discrete and continuous outcomes. Biometrics 1986; 42:121-130
18. Wilcox ME, Chong CA, Niven DJ, et al: Do intensivist staffng patterns infuence hospital mortality following ICU admission? A systematic review and meta-analyses. Crit Care Med 2013; 41:2253-2274
19. Kelly DM, Kutney-Lee A, McHugh MD, et al: Impact of critical care nursing on 30-day mortality of mechanically ventilated older adults. Crit Care Med 2014; 42:1089-1095
20. Wse KR, Akopov VA, Williams BR Jr, et al: Hospitalists and intensiv-ists in the medical ICU: A prospective observational study comparing mortality and length of stay between two staffng models. J Hosp Med 2012; 7:183-189
21. Costa DK, Wallace DJ, Barnato AE, et al: Nurse practitioner/physician assistant staffng and critical care mortality. Chest 2014; 146:1566-1573
22. Costa DK, Barg FK, Asch DA, et al: Facilitators of an interprofessional approach to care in medical and mixed medical/surgical ICUs: A mul-ticenter qualitative study. Res Nurs Health 2014; 37:326-335
23. Kahn JM, Brake H, Steinberg KP: Intensivist physician staffng and the process of care in academic medical centres. Qual Saf Health Care 2007; 16:329-333
24. Cooke CR, Watkins TR, Kahn JM, et al: The effect of an intensive care unit staffng model on tidal volume in patients with acute lung injury. Crit Care 2008; 12:R134. Available at: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=18980682&retmode=r ef&cmd=prlinks. Accessed March 28, 2015
25. Esteban A, Frutos-Vivar F, Muriel A, et al: Evolution of mortality over time in patients receiving mechanical ventilation. Am J Respir Crit Care Med 2013; 188:220-230
26. Sinuff T, Cook DJ, Giacomini M: How qualitative research can contribute to research in the intensive care unit. J Crit Care 2007; 22:104-111