ArticleQuality & safety in health care2007
Intensivist physician staffing and the process of care in academic medical centres.
Article in Quality & safety in health care, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01413009 (Awakening-Breathing Coordination, Delirium Monitoring/Management & Early Mobility), which is not on this map. Cited by 42 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Awakening-Breathing Coordination, Delirium Monitoring/Management & Early Mobility (ABCDE) Protocol
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Two decades of mortality trends among patients with severe sepsis: a comparative meta-analysis*.Critical care medicine · 2014Pooled it
- The effect of telemedicine in critically ill patients: systematic review and meta-analysis.Critical care (London, England) · 2012Pooled it
- A randomized trial of nighttime physician staffing in an intensive care unit.The New England journal of medicine · 2013Trial
- Article
- Inadequate intensive care physician supply in France: a point-prevalence prospective study.Annals of intensive care · 2024Article
- Intensivist coverage and critically ill COVID-19 patient outcomes: a population-based cohort study.Journal of intensive care · 2023Article
- Intensivist physician-to-patient ratios and mortality in the intensive care unit.Intensive care medicine · 2023Article
- Article
- Cardiac Critical Care: The Evolution of a Novel Subspecialty.Methodist DeBakey cardiovascular journal · 2022Review
- Intensive care unit versus high-dependency care unit for patients with acute heart failure: a nationwide propensity score-matched cohort study.Journal of intensive care · 2021Article
- Resource-rich Intensive Care Units vs. Standard Intensive Care Units on Patient Mortality: A Nationwide Inpatient Database Study.JMA journal · 2021Article
- A scoping review of registry captured indicators for evaluating quality of critical care in ICU.Journal of intensive care · 2021Article
- The Society of Critical Care Medicine at 50 Years: ICU Organization and Management.Critical care medicine · 2021Article
- Organizational Characteristics Associated With ICU Liberation (ABCDEF) Bundle Implementation by Adult ICUs in Michigan.Critical care explorations · 2020Article
- A multinational survey on the infrastructural quality of paediatric intensive care units.Annals of intensive care · 2018Article
- Structural, Nursing, and Physician Characteristics and 30-Day Mortality for Patients Undergoing Cardiac Surgery in Pennsylvania.Critical care medicine · 2017Article
- Outcome of acute respiratory distress syndrome in university and non-university hospitals in Germany.Critical care (London, England) · 2017Observational
- Evidence supports the superiority of closed ICUs for patients and families: Yes.Intensive care medicine · 2017Article
- The Association Between Daytime Intensivist Physician Staffing and Mortality in the Context of Other ICU Organizational Practices: A Multicenter Cohort Study.Critical care medicine · 2015Article
- Hiding in plain sight: communication theory in implementation science.Implementation science : IS · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
backgroundAlthough intensivist physician staffing is associated with improved outcomes in critical care, little is known about the mechanism leading to this observation.
objectiveTo determine the relationship between intensivist staffing and select process-based quality indicators in the intensive care unit. RESEARCH
designRetrospective cohort study in 29 academic hospitals participating in the University HealthSystem Consortium Mechanically Ventilated Patient Bundle Benchmarking Project. PATIENTS: 861 adult patients receiving prolonged mechanical ventilation in an intensive care unit.
resultsPatient-level information on physician staffing and process-of-care quality indicators were collected on day 4 of mechanical ventilation. By day 4, 668 patients received care under a high intensity staffing model (primary intensivist care or mandatory consult) and 193 patients received care under a low intensity staffing model (optional consultation or no intensivist). Among eligible patients, those receiving care under a high intensity staffing model were more likely to receive prophylaxis for deep vein thrombosis (risk ratio 1.08, 95% CI 1.00 to 1.17), stress ulcer prophylaxis (risk ratio 1.10, 95% CI 1.03 to 1.18), a spontaneous breathing trial (risk ratio 1.37, 95% CI 0.97 to 1.94), interruption of sedation (risk ratio 1.64, 95% CI 1.13 to 2.38) and intensive insulin treatment (risk ratio 1.40, 95% CI 1.18 to 1.79) on day 4 of mechanical ventilation. Models accounting for clustering by hospital produced similar estimates of the staffing effect, except for prophylaxis against thrombosis and stress ulcers.
conclusionsHigh intensity physician staffing is associated with increased use of evidence-based quality indicators in patients receiving mechanical ventilation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.