Interprofessional Team Staffing in U.S. Intensive Care Units

Area of Science:

• Critical Care Medicine
• Healthcare Management
• Health Services Research

Background:

• There is limited data and no consensus on the composition of interdisciplinary healthcare worker (HCW) teams in intensive care units (ICUs).
• Understanding pre-pandemic ICU staffing is crucial for establishing baseline models and identifying areas for improvement.

Purpose of the Study:

• To define the composition and variability of HCW staffing in U.S. adult ICUs prior to the COVID-19 pandemic.
• To analyze the presence and participation of various HCW types in daily ICU care and formal clinical rounds.

Main Methods:

• A national survey of 574 adult ICUs assessed the availability and participation of 11 HCW types in care and rounds.
• Data were analyzed descriptively to identify predominant and diverse staffing patterns.
• HCW types were grouped into six categories for analysis, with bedside nurses included in both availability and rounds.

Main Results:

• A core team of bedside nurses, intensivists, respiratory therapists, and pharmacists was available in most ICUs (88%).
• Significant variability existed in the full team composition, with 28 different combinations of six HCW groupings identified.
• Nearly all ICUs (96%) held interprofessional rounds at least five days a week, often including weekends, though participation varied by HCW type.

Conclusions:

• Intensive care unit (ICU) care consistently involves a core team of bedside nurses, intensivists, respiratory therapists, and pharmacists.
• Beyond this core, the presence of other healthcare worker (HCW) types demonstrates considerable variability in ICU staffing.
• Interprofessional rounds are a common practice in ICUs, with most conducting them daily and many including weekend sessions.