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01-09-2016 | Editorial

Nighttime physician staffing improves patient outcomes: we are not sure

Authors: Bertrand Guidet, Marcio Soares, Kathryn Rowan

Published in: Intensive Care Medicine | Issue 9/2016

Excerpt

The financial cost to implement dedicated nighttime senior physician staffing in intensive care units (ICUs) would not be inconsiderable to any healthcare system. Therefore, prior to embarking on such a financial outlay, there would need to be substantive evidence around two major areas: (1) evidence that there is a nighttime “problem” and (2) evidence that dedicated nighttime ICU senior physician staffing fixed/mitigated the nighttime “problem” and delivered benefits, including economic benefits, to offset the financial outlay. …

Guidet B, Bion J (2014) Night thoughts. Intensive Care Med 40:1586–1588CrossRefPubMed

Cavallazzi R, Marik PE, Hirani A et al (2010) Association between time of admission to the ICU and mortality: a systematic review and metaanalysis. Chest 138:68–75CrossRefPubMed

Garland A, Gershengorn HB (2013) Staffing in ICUs: physicians and alternative staffing models. Chest 143:214–221CrossRefPubMed

Wallace DJ (2016) Nighttime physician staffing improves patient outcomes: yes. Intensive Care Med. doi:10.1007/s00134-016-4371-y PubMed

Kerlin MP, Halpern SD (2016) Nighttime physician staffing improves patient outcomes: no. Intensive Care Med. doi:10.1007/s00134-016-4367-7

Wilcox ME, Chong CA, Niven DJ et al (2013) Do intensivist staffing patterns influence hospital mortality following ICU admission? A systematic review and meta-analyses. Crit Care Med 41:2253–2274CrossRefPubMed

Garland A, Roberts D, Graff L (2012) Twenty-four-hour intensivist presence: a pilot study of effects on intensive care unit patients, families, doctors, and nurses. Am J Respir Crit Care Med 185:738–743CrossRefPubMed

Kerlin MP, Small DS, Cooney E et al (2013) A randomized trial of nighttime physician staffing in an intensive care unit. N Engl J Med 368:2201–2209CrossRefPubMedPubMedCentral

Maltese F, Adda M, Bablon A et al (2016) Night shift decreases cognitive performance of ICU physicians. Intensive Care Med 42:393–400. doi:10.1007/s00134-015-4115-4 CrossRefPubMed

10.

Rhodes A, Ferdinande P, Flaatten H, Guidet B, Metnitz PG, Moreno RP (2012) The variability of critical care beds numbers in Europe. Intensive Care Med 38:1647–1653CrossRefPubMed

11.

Luyt CH, Combes A, Aegerter P, Guidet B, Trouillet JL, Gibert C, Chastre J (2007) Mortality among patients admitted to intensive care units during weekday shifts compared to “off” hours. Crit Care Med 35:3–11

12.

Shorr AF, Angus DC (2006) Do intensive care unit patients have intensive care unit physicians? Unfortunately not. Crit Care Med 34:1834–1835CrossRefPubMed

13.

Soares M, Bozza FA, Angus DC et al (2015) Organizational characteristics, outcomes, and resource use in 78 Brazilian intensive care units: the ORCHESTRA study. Intensive Care Med 41:2149–2160CrossRefPubMed

14.

Vincent JL, Suter P, Bihari D et al (1997) Organization of intensive care units in Europe: lesson from the EPIC study. Intensive Care Med 23:1181–1184CrossRefPubMed

15.

Banerjee R, Naessens JM, Seferian EG et al (2011) Economic implications of nighttime attending intensivist coverage in a medical intensive care unit. Crit Care Med 39:1257–1262CrossRefPubMedPubMedCentral

Title: Nighttime physician staffing improves patient outcomes: we are not sure
Authors: Bertrand Guidet
Marcio Soares
Kathryn Rowan
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 9/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-016-4422-4

At a glance: The STEP trials

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Nighttime physician staffing improves patient outcomes: we are not sure

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