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Clinical Full-Time Equivalent in PICUs: Survey of the U.S. Pediatric Critical Care Chiefs Network, 2020-2022
Nicholas A Ettinger1, Steven Loscalzo2, Hongyan Liu3
1Division of Pediatric Critical Care, Department of Pediatrics, Emory School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA.
Insights
Pediatric critical care (PCC) physician workload varies by unit size, with larger units having fewer night shifts. This study clarifies clinical full-time equivalent (cFTE) responsibilities for workforce planning.
Area of Science:
- Pediatric critical care medicine
- Healthcare workforce analysis
- Physician workload studies
Background:
- Accurate workforce planning for pediatric critical care (PCC) requires understanding physician clinical responsibilities.
- Current staffing models and the spectrum of clinical duties for PCC physicians need detailed description.
- The Pediatric Critical Care Chiefs Network (PC3N) is a key network for gathering this data.
Purpose of the Study:
- To characterize the clinical workload of a clinical full-time equivalent (cFTE) in U.S. pediatric intensive care units (PICUs).
- To inform effective workforce planning and resource allocation within PCC.
- To describe variations in cFTE responsibilities across different PICU settings.
Main Methods:
- A cross-sectional survey was administered to PICU division chiefs or designees within the PC3N from 2020 to 2022.
- Three surveys captured unit characteristics and clinical responsibilities for a 1.0 cFTE intensivist.
- Response rate was 30% (46 out of 156 PICUs).
Main Results:
- The construction of a cFTE (using hours, shifts, weeks, or % FTE) did not significantly vary by unit size or faculty numbers.
- Median annual clinical responsibilities for a 1.0 cFTE: 1750 clinical hours, 142 clinical shifts, 13 weeks of service, and 52 night shifts.
- Larger PICUs reported fewer night shifts but covered more beds per shift.
Conclusions:
- This PC3N survey offers a contemporary view of cFTE physician clinical responsibilities in PCC.
- A 1.0 cFTE workload is not uniform and is influenced by PICU size.
- The method used to define a cFTE showed no correlation with the actual clinical responsibilities undertaken.
Objectives:
To inform workforce planning for pediatric critical care (PCC) physicians, it is important to understand current staffing models and the spectrum of clinical responsibilities of physicians. Our objective was to describe the expected workload associated with a clinical full-time equivalent (cFTE) in PICUs across the U.S. Pediatric Critical Care Chiefs Network (PC3N).
Design:
Cross-sectional survey.
Setting:
PICUs participating in the PC3N.
Subjects:
PICU division chiefs or designees participating in the PC3N from 2020 to 2022.
Interventions:
None.
Measurements And Main Results:
A series of three surveys were used to capture unit characteristics and clinical responsibilities for an estimated 1.0 cFTE intensivist. Out of a total of 156 PICUs in the PC3N, the response rate was 46 (30%) to all three distributed surveys. Respondents used one of four models to describe the construction of a cFTE-total clinical hours, total clinical shifts, total weeks of service, or % full-time equivalent. Results were stratified by unit size. The model used for construction of a cFTE did not vary significantly by the total number of faculty nor the total number of beds. The median (interquartile range) of clinical responsibilities annually for a 1.0 cFTE were: total clinical hours 1750 (1483-1858), total clinical shifts 142 (129-177); total weeks of service 13.0 (11.3-16.0); and total night shifts 52 (36-60). When stratified by unit size, larger units had fewer nights or overnight hours, but covered more beds per shift.
Conclusions:
This survey of the PC3N (2020-2022) provides the most contemporary description of clinical responsibilities associated with a cFTE physician in PCC. A 1.0 cFTE varies depending on unit size. There is no correlation between the model used to construct a cFTE and the associated clinical responsibilities.
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