ArticleIntensive care medicine2011
The relationship between workload and medical staffing levels in a paediatric cardiac intensive care unit.
Article in Intensive care medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 25 citations in OpenAlex.
- Acuity of Patients Undergoing Congenital Heart Surgery During Hospitalization.Journal of the American Heart Association · 2026Article
- Association between off-hour admission of critically ill children to intensive care units and mortality in a Japanese registry.Scientific reports · 2021Article
- Time of Pediatric Intensive Care Unit Admission and Mortality: A Systematic Review and Meta-Analysis.Journal of pediatric intensive care · 2020Review
- Operations research in intensive care unit management: a literature review.Health care management science · 2018Review
- [Cross sectional study of structural quality of German intensive care units. A reevaluation of the DIVI register].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2013Article
- Year in review in Intensive Care Medicine 2011: III. ARDS and ECMO, weaning, mechanical ventilation, noninvasive ventilation, pediatrics and miscellanea.Intensive care medicine · 2012Review
- Change in Ratio of Observed-to-Expected Deaths in Pediatric Patients after Implementing a Closed Policy in an Adult ICU That Admits Children.Critical care research and practice · 2012Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the matching between workload in a paediatric cardiac intensive care unit (ICU) and the corresponding medical staffing levels over a 24-h period.
designA review of workload measured by: (a) admissions, (b) severity of illness in admissions using case-mix descriptors and mortality as a proxy, (c) cardiac arrests (CA) and (d) extracorporeal membrane oxygenation (ECMO) cannulations. An evaluation of matching between workload and medical staff schedules.
settingA tertiary paediatric cardiac ICU. PATIENTS: 2,799 admissions over a 49-month period.
resultsNew admissions peaked in the evening, and the ratio of doctors' hours to admissions was lowest between 1359 and 2000 h. Although only 515 (17.3%) cases were admitted between 2000 and 0759 h, these were more likely to be emergencies, to have higher Paediatric Index of Mortality 2 (PIM2) scores and to die (p < 0.001). There was an increased adjusted risk of death in admissions between 2000 and 0159 h (p = 0.021). There was no difference in the occurrence of either CA (p = 0.41) or ECMO (p = 0.95) between day and night. The ratio of doctors' hours to CAs and ECMOs was lowest from 2000 to 0800 h. The conventional medical staffing roster generated the greatest concentration of staff in the morning, reducing to the lowest level between 0200 and 0759 h.
conclusionsWorkload was most intense for the in-house team at night, in terms of sicker admissions, ECMOs and cardiac arrests. Conventional roster patterns may not offer ideal matching between staffing and workload. Data analysis of variable and urgent workload may be used to inform medical rosters.
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