Healthcare News & Insights

Hospitals fall short with physician staffing in ICU

Critically ill patients in intensive care units usually need a great deal of medical attention. And they have better outcomes when hospitals meet the appropriate staffing requirements for the ICU. However, many hospitals are opting not to hire the most specialized physicians, and this practice may negatively affect patients’ recovery. 

A new report from the Leapfrog Group and Castlight HealthGettyImages-91156522 shows the current state of physician staffing in the ICU.

To ensure patient safety, the Leapfrog Group has created three important staffing standards hospitals should follow for the ICU:

  1. At least one board-certified intensivist must manage or co-manage all ICU patients.
  2. Intensivists should be present during the daytime for eight hours each day, seven days a week. They should provide care in one ICU exclusively for the duration of each shift.
  3. When not on site (e.g., telemedicine providers), intensivists must return pages within five minutes at least 95% of the time. Once reached, they should arrange for clinical staff to address the patient’s problem within five minutes.

Why more intensivists are needed

The presence of intensivists, or doctors who are trained and certified to provide critical care, is important to ICU patients’ recovery.

According to the report, past research has shown that patients cared for by on-site intensivists are 40% less likely to die in the ICU. (When patients are cared for by intensivists through telemedicine, they’re up to 30% less likely to die.) They also have shorter hospital stays and a lower chance of contracting any hospital-acquired infections.

Despite these benefits, many hospitals aren’t hiring full-time intensivists, often opting to use general hospitalists instead. Even when giving hospitals partial credit for having an intensivist via telehealth, only 47% of facilities meet the Leapfrog Group’s staffing standards. That means over half of hospitals are putting patients in the ICU at risk.

Some states are doing better than others with adopting the Leapfrog standards. In Arizona, 87% of facilities meet the intensivist staffing requirement – the highest rates in the country. South Carolina’s hospitals fared the worst; only 26% of its facilities meet the standards.

Rates have increased over time. In 2007, only 30% of hospitals met Leapfrog’s ICU staffing standards. But there’s still room for improvement – especially since a significant number of hospitals decline to report their ICU staffing practices at all.

Hospitals’ next steps

In a press release about the report, Leapfrog calls upon hospitals to be more mindful of staffing their ICUs so patients can receive the highest quality care possible. It’s also asking for more transparency from facilities about the number of intensivists they have on staff.

Hospitals that aren’t using intensivists in the ICU as often as recommended may want to rethink their staffing policies, especially as patient outcomes become more important to hospitals’ bottom line. Having more trained critical care physicians on staff could make the difference between life and death for vulnerable patients.

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