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Erschienen in: Critical Care 6/2013

01.12.2013 | Letter

Night-time intensivists - waste of resources or failure of process optimization?

Erschienen in: Critical Care | Ausgabe 6/2013

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Excerpt

Dr Levy [1] commented on the study of Kerlin and colleagues [2] on the relevance, or futility, of night-time intensivists. Kerlin and colleagues compared in-hospital night-time intensivist presence with night-time phone consultations by daytime intensivists (control) with regard to ICU length of stay, hospital mortality, and readmission rate. Randomized 7 day blocks of night-time intensivist presence versus control had no effect. Previously, Dr Levy found no association between high-intensity daytime staffing and mortality, and no benefit of night-time intensivists in high-intensity ICUs in a retrospective study [3]. Dr Levy suggests that 'it is time…to redirect the resources proposed for night-time intensivists elsewhere'. Conclusions on night-time intensivists, based on these two studies [2, 3] may be misleading and premature. …
Literatur
2.
Zurück zum Zitat Kerlin MP, Small DS, Cooney E, Fuchs BD, Bellini LM, Mikkelsen ME, Schweickert WD, Bakhru RN, Gabler NB, Harhay MO, Hansen-Flaschen J, Halpern SD: A randomized trial of nighttime physician staffing in an intensive care unit. N Engl J Med 2013, 368: 2201-2209. 10.1056/NEJMoa1302854PubMedCentralCrossRefPubMed Kerlin MP, Small DS, Cooney E, Fuchs BD, Bellini LM, Mikkelsen ME, Schweickert WD, Bakhru RN, Gabler NB, Harhay MO, Hansen-Flaschen J, Halpern SD: A randomized trial of nighttime physician staffing in an intensive care unit. N Engl J Med 2013, 368: 2201-2209. 10.1056/NEJMoa1302854PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Levy MM, Rapoport J, Lemeshow S, Chalfin DB, Phillips G, Danis M: Association between critical care physician management and patient mortality in the intensive care unit. Ann Int Med 2008, 148: 801-809. 10.7326/0003-4819-148-11-200806030-00002PubMedCentralCrossRefPubMed Levy MM, Rapoport J, Lemeshow S, Chalfin DB, Phillips G, Danis M: Association between critical care physician management and patient mortality in the intensive care unit. Ann Int Med 2008, 148: 801-809. 10.7326/0003-4819-148-11-200806030-00002PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Vincent JL, Pinsky MR, Sprung CL, Levy M, Marini JJ, Payen D, Rhodes A, Takala J: The pulmonary artery catheter: in medio virtus. Crit Care Med 2008, 36: 3093-3096. 10.1097/CCM.0b013e31818c10c7CrossRefPubMed Vincent JL, Pinsky MR, Sprung CL, Levy M, Marini JJ, Payen D, Rhodes A, Takala J: The pulmonary artery catheter: in medio virtus. Crit Care Med 2008, 36: 3093-3096. 10.1097/CCM.0b013e31818c10c7CrossRefPubMed
5.
Zurück zum Zitat Jakob SM, Lubszky S, Friolet R, Rothen HU, Kolarova A, Takala J: Sedation and weaning from mechanical ventilation: effects of process optimization outside a clinical trial. J Crit Care 2007, 22: 219-228. 10.1016/j.jcrc.2007.01.001CrossRefPubMed Jakob SM, Lubszky S, Friolet R, Rothen HU, Kolarova A, Takala J: Sedation and weaning from mechanical ventilation: effects of process optimization outside a clinical trial. J Crit Care 2007, 22: 219-228. 10.1016/j.jcrc.2007.01.001CrossRefPubMed
6.
Zurück zum Zitat Wallace DJ, Angus DC, Barnato AE, Kramer AA, Kahn JM: Nighttime intensivist staffing and mortality among critically ill patients. N Engl J Med 2012, 366: 2093-2101. 10.1056/NEJMsa1201918PubMedCentralCrossRefPubMed Wallace DJ, Angus DC, Barnato AE, Kramer AA, Kahn JM: Nighttime intensivist staffing and mortality among critically ill patients. N Engl J Med 2012, 366: 2093-2101. 10.1056/NEJMsa1201918PubMedCentralCrossRefPubMed
Metadaten
Titel
Night-time intensivists - waste of resources or failure of process optimization?
Publikationsdatum
01.12.2013
Erschienen in
Critical Care / Ausgabe 6/2013
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc13170

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