Nicholas M Mohr1, John Collier2, Elizabeth Hassebroek3, Heather Groth4. 1. Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA; Division of Critical Care, Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA. Electronic address: nicholas-mohr@uiowa.edu. 2. Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA. 3. Department of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. 4. Department of Emergency Medicine, University of Virginia, PO Box 800699, Charlottesville, VA 22908, USA.
Abstract
PURPOSE: This study aimed to characterize intensive care unit (ICU) physician staffing patterns in a predominantly rural state. MATERIALS AND METHODS: A prospective telephone survey of ICU nurse managers in all Iowa hospitals with an ICU was conducted. RESULTS: Of 122 Iowa hospitals, 64 ICUs in 58 (48%) hospitals were identified, and 46 (72%) responded to the survey. Most ICUs (96%) used an open admission model and cared for undifferentiated medical and surgical patients (88%), and only 27% of open ICUs required critical care or pulmonary consultation for admitted patients. Most (59%) Iowa ICUs had a critical care physician or pulmonologist available, and high-intensity staffing was practiced in 30% of ICUs. Most physicians identified as practicing critical care (63%) were not board certified in critical care. Critical care physicians were available in a minority of hospitals routinely for inpatient intubation and cardiac arrest management (29% and 10%, respectively), and emergency physicians and other practitioners commonly responded to emergencies throughout the hospital. CONCLUSIONS: Many Iowa hospitals have ICUs, and staffing patterns in Iowa ICUs mirror closely national staffing practices. Most ICUs are multispecialty, open ICUs in community hospitals. These factors should inform training and resource allocation for intensivists in rural states.
PURPOSE: This study aimed to characterize intensive care unit (ICU) physician staffing patterns in a predominantly rural state. MATERIALS AND METHODS: A prospective telephone survey of ICU nurse managers in all Iowa hospitals with an ICU was conducted. RESULTS: Of 122 Iowa hospitals, 64 ICUs in 58 (48%) hospitals were identified, and 46 (72%) responded to the survey. Most ICUs (96%) used an open admission model and cared for undifferentiated medical and surgical patients (88%), and only 27% of open ICUs required critical care or pulmonary consultation for admitted patients. Most (59%) Iowa ICUs had a critical care physician or pulmonologist available, and high-intensity staffing was practiced in 30% of ICUs. Most physicians identified as practicing critical care (63%) were not board certified in critical care. Critical care physicians were available in a minority of hospitals routinely for inpatient intubation and cardiac arrest management (29% and 10%, respectively), and emergency physicians and other practitioners commonly responded to emergencies throughout the hospital. CONCLUSIONS: Many Iowa hospitals have ICUs, and staffing patterns in Iowa ICUs mirror closely national staffing practices. Most ICUs are multispecialty, open ICUs in community hospitals. These factors should inform training and resource allocation for intensivists in rural states.
Authors: Steven A Ilko; J Priyanka Vakkalanka; Azeemuddin Ahmed; Karisa K Harland; Nicholas M Mohr Journal: Crit Care Med Date: 2019-05 Impact factor: 7.598
Authors: Cameron J Gettel; Maureen E Canavan; Margaret B Greenwood-Ericksen; Vivek L Parwani; Andrew S Ulrich; Randy L Pilgrim; Arjun K Venkatesh Journal: Ann Emerg Med Date: 2021-03-24 Impact factor: 6.762