The effect of physician staffing model on patient outcomes in a medical progressive care unit

Journal of Critical Care
E J YooM S Sherman

Abstract

Although evidence supports the impact of intensivist physician staffing in improving intensive care unit (ICU) outcomes, the optimal coverage for progressive care units (PCU) is unknown. We sought to determine how physician staffing models influence outcomes for intermediate care patients. We conducted a retrospective observational comparison of patients admitted to the medical PCU of an academic hospital during 12-month periods of high-intensity and low-intensity staffing. A total of 318 PCU patients were eligible for inclusion (143 high-intensity and 175 low-intensity). We found that low-intensity patients were more often stepped up from the emergency department and floor, whereas high-intensity patients were ICU transfers (61% vs 42%, P = .001). However, Mortality Probability Model scoring was similar between the 2 groups. In adjusted analysis, there was no association between intensity of staffing and hospital mortality (odds ratio, 0.84; 95% confidence interval, 0.36-1.99; P = .69) or PCU mortality (odds ratio, 0.96; 95% confidence interval, 0.38-2.45; P = .69). There was also no difference in subsequent ICU admission rates or in PCU length of stay. We found no evidence that high-intensity intensivist physician staffing im...Continue Reading

References

Jan 26, 1999·Journal of Accident & Emergency Medicine·J V PappachanG B Smith
Nov 5, 1999·Critical Care Medicine·D C ChengE Knobel
Feb 8, 2000·Intensive Care Medicine·J L Vincent, H Burchardi
Dec 6, 2000·JAMA : the Journal of the American Medical Association·D C AngusUNKNOWN Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS)
Mar 3, 2007·Intensive & Critical Care Nursing : the Official Journal of the British Association of Critical Care Nurses·Katia Grillo PadilhaEliana Rodrigues Carlessi Mayor
Apr 2, 2008·Critical Care Medicine·Kenneth Krell
Jun 3, 2011·Critical Care Nurse·Kathleen M Stacy
Jan 25, 2012·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Juan Felipe LucenaJorge Quiroga
May 9, 2012·Critical Care Medicine·Hayley B GershengornHannah Wunsch
May 23, 2012·The New England Journal of Medicine·David J WallaceJeremy M Kahn
Oct 17, 2013·PloS One·Juan F LucenaJorge Quiroga
Jan 8, 2014·Critical Care Medicine·Lora A ReineckJeremy M Kahn
Aug 28, 2014·American Journal of Respiratory and Critical Care Medicine·Meghan Prin, Hannah Wunsch

❮ Previous
Next ❯

Citations

Feb 13, 2018·Journal of Intensive Care Medicine·Blair WendlandtLydia Chang
Oct 23, 2019·Journal of Intensive Care Medicine·Rebeccah M BruscaDavid N Hager
Aug 5, 2017·Critical Care Research and Practice·Joost D J PlateFalco Hietbrink
Aug 29, 2018·Critical Care Research and Practice·Joost D J PlateFalco Hietbrink

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.