Nighttime Intensivist Staffing and Mortality among Critically Ill Patients

Many ICUs are moving to models with intensivist staffing 24 hours a day. This study examined outcomes based on ICU staffing models, using data from ICU databases. A mortality benefit was associated with nighttime intensivist staffing only in ICUs with low-intensity daytime staffing. Daytime intensivist physician staffing has been consistently associated with improved outcomes among patients admitted to an intensive care unit (ICU). 1 This observation has led to policy initiatives calling for expansion of the intensivist staffing model to encompass all critically ill patients. 1 , 2 More recently, some experts have proposed further extending the intensivist staffing model to provide care around the clock, with intensivist physicians remaining in the ICU overnight. 3 – 6 Proponents of 24-hour intensivist staffing suggest that nighttime intensivist staffing may result in earlier establishment of treatment plans, more timely resuscitation of patients in unstable condition, uninterrupted provision of complex care, . . .