- Section 1 ICU organization and management
- Part 1.1 The intensive care unit
- Chapter 1 Design of the ICU
- Chapter 2 Staffing models in the ICU
- Chapter 3 Rapid response teams for the critically ill
- Chapter 4 In-hospital transfer of the critically ill
- Chapter 5 Pre- and inter-hospital transport of the critically ill and injured
- Chapter 6 Regional critical care delivery systems
- Chapter 7 Integration of information technology in the ICU
- Chapter 8 Multiple casualties and disaster response in critical care
- Chapter 9 Management of pandemic critical illness
- Part 1.2 Communication
- Part 1.3 Training
- Part 1.4 Safety and quality
- Part 1.5 Governance
- Part 1.6 Research
- Part 1.7 Medico-legal and ethical issues
- Part 1.8 Critical illness risk prediction
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 7) Staffing models in the ICU
- Chapter:
- (p. 7) Staffing models in the ICU
- Author(s):
Tim Buchman
and Michael Sterling
- DOI:
- 10.1093/med/9780199600830.003.0002
Three decades ago a critical care provider surplus was forecast. Projections changed at the turn of the century when the Committee on Manpower of Pulmonary and Critical Care Societies (COMPACCS) report was issued. Demographers, statisticians, and clinicians used population, patient, hospital, and provider data to forecast that the supply for critical care physicians would not keep pace with demand, and that the shortfall would be around 22% by 2020, climbing to 35% by 2030. In 2006, the Health Resources and Services Administration (HRSA) similarly forecast a significant shortage of intensivists by 2020. All signs suggest that the COMPACCS prediction is correct. This chapter describes and discusses three novel strategies by which intensivist expertise can be leveraged to provide care for a larger group of critically-ill patients. The three strategies include the use of hospitalists, engagement of affiliate providers (nurse practitioners and physician assistants with advanced critical care competencies), and investment in tele- ICU services. These strategies are complementary and can be combined to provide models tailored to local needs and resources.
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- Section 1 ICU organization and management
- Part 1.1 The intensive care unit
- Chapter 1 Design of the ICU
- Chapter 2 Staffing models in the ICU
- Chapter 3 Rapid response teams for the critically ill
- Chapter 4 In-hospital transfer of the critically ill
- Chapter 5 Pre- and inter-hospital transport of the critically ill and injured
- Chapter 6 Regional critical care delivery systems
- Chapter 7 Integration of information technology in the ICU
- Chapter 8 Multiple casualties and disaster response in critical care
- Chapter 9 Management of pandemic critical illness
- Part 1.2 Communication
- Part 1.3 Training
- Part 1.4 Safety and quality
- Part 1.5 Governance
- Part 1.6 Research
- Part 1.7 Medico-legal and ethical issues
- Part 1.8 Critical illness risk prediction
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care