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Survey of Intensivist Coverage and Interprofessional Team Staffing in Canadian ICUs
Hannah Wunsch1,2, Venika Manoharan2, Andrea Hill2
1Department of Anesthesiology, Weill Cornell Medicine, New York, NY.
Objective:
To provide national data on intensivist coverage and interprofessional team staffing in Canadian ICUs.
Design:
Cross-sectional survey.
Setting:
All Canadian hospitals identified as potentially having an adult ICU.
Subjects:
ICU nurse/physician leaders.
Interventions:
None.
Measurements And Main Results:
We contacted ICU nurse/physician leadership by email. The questionnaire included questions about interprofessional ICU staffing, availability and roles. Questionnaires were administered from September 2024 to February 2025; data were cleaned and analyzed February to May 2025. We included responses from 137 unique adult ICUs in 123 hospitals (40.9% of 301 hospitals queried), representing all Canadian provinces and territories with ICUs. ICU size varied (median [interquartile range]: 14 beds [8, 20]); most were for mixed patient populations (123 [89.8%]) and had intensivist coverage (119 [86.9%]). Among units with intensivists, they were onsite 24 hr/d in 28/119 (23.5%), and intensivists had simultaneous responsibilities outside the ICU in 47/119 (39.5%). Physicians-in-training were present on weekdays in 112/137 units (81.8%) and advanced practice providers (APPs) in 32/136 (23.5%). For mechanically ventilated patients, the nurse:patient ratio was most commonly 1:1 (66.7%). Respiratory therapists were available on weekdays in 133/137 (97.1%), clinical pharmacists in 123/136 (90.4%) and physical therapists in 126/134 (94.0%).
Conclusions:
Most Canadian adult ICUs were staffed by intensivists with less than 25% having onsite intensivist coverage 24 hr/d. Physicians-in-training were present in the majority of ICUs, whereas APPs were uncommon. Nurses most commonly provided care for one mechanically ventilated patient each shift. These data establish contemporary staffing benchmarks to inform assessment of baseline ICU workforce needs and guide surge planning at local, provincial, and national levels. They also enable international comparisons and provide essential context for interpreting Canadian critical care research.
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