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Area of Science:

  • Critical Care Medicine
  • Healthcare Management

Background:

  • Increasing demand for critical care expertise necessitates innovative staffing models.
  • Advanced Practice Providers (APPs) are emerging as a solution to intensivist limitations.
  • This study evaluates APP team performance in a Cardiac Intensive Care Unit (CICU).

Purpose of the Study:

  • To compare patient outcomes between APP-led and housestaff-led teams in the CICU.
  • To assess the impact of APP staffing on mortality and length of stay.
  • To evaluate the effect of APP teams on cardiology fellowship training.

Main Methods:

  • Retrospective study comparing two CICU teams (housestaff vs. APPs) from March 2022 to July 2023.
  • Analysis of 1,620 patient admissions, focusing on mortality and length of stay.
  • Multivariable Cox regression and Kaplan-Meier analyses for primary outcome assessment.

Main Results:

  • No significant differences in CICU mortality (8.4% vs. 8.2%) or in-hospital mortality (13.5% vs. 13.8%) between APP and housestaff teams.
  • Similar patient demographics, admitting diagnoses, and use of critical care interventions were observed.
  • APP teams showed improved fellowship rotation scores (3.87 to 4.61, P < 0.0001).

Conclusions:

  • APP-managed and housestaff-managed teams yield comparable patient mortality in the CICU.
  • The findings support the integration of APPs into critical care staffing models.
  • APP utilization may enhance the quality of cardiology fellowship training.