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Staffing models in the ICU 

Staffing models in the ICU
Chapter:
Staffing models in the ICU
Author(s):

Tim Buchman

and Michael Sterling

DOI:
10.1093/med/9780199600830.003.0002
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date: 01 December 2020

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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