The severe shortage of specially-trained intensivist physicians has hospital intensive care units (ICUs) nationwide struggling to staff units with critical care teams led by intensivists, even though the presence of these specially trained physicians reduces the risk of death for patients in the ICU. A new Penn Medicine report found that replacing intensivist-led teams with multidisciplinary care teams can also reduce the risk of dying in intensive care units. The study appears in the February 22 edition of the Archives of Internal Medicine.
"Hospitals without intensivists can still achieve significant reductions in mortality in their ICUs by implementing a multidisciplinary, team-based approach," said the study's lead author, Jeremy Kahn, MD, MS, Assistant Professor of Medicine at the University of Pennsylvania School of Medicine. "Patient outcomes are improved when physicians, nurses, respiratory therapists, clinical pharmacists and other staff members work together to provide critical care as a team."
There are more than four million intensive care unit admissions in the U.S. each year. With an intensivist at the helm, intensive care units have shown to lower mortality rates, even when caring for the sickest patients. Yet there are not enough trained intensivists to meet either current or future demand, and only a minority of ICUs are currently staffed with intensivists.
The study authors examined data from 112 hospitals in Pennsylvania comparing outcomes from ICUs that both were and were not staffed by intensivists. The researchers found that a multidisciplinary approach to care teams, with or without an intensivist, was associated with a 16 percent reduction in the odds of death. This was comparable to an intensivist alone. When hospitals employed both a multidisciplinary care team and an intensivist physician, there was a 22 percent reduction in the risk of death during an ICU stay.