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Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0000000000000032
Feature Articles

Survey of In-House Coverage by Pediatric Intensivists: Characterization of 24/7 In-Hospital Pediatric Critical Care Faculty Coverage*

Rehder, Kyle J. MD1; Cheifetz, Ira M. MD, FCCM1; Markovitz, Barry P. MD, MPH2; Turner, David A. MD1; for the Pediatric Acute Lung Injury and Sepsis Investigators Network

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Objective: To characterize the current state of 24/7 in-hospital pediatric intensivist coverage in academic PICUs, including perceptions of faculty and trainees regarding the advantages and disadvantages of in-hospital coverage.

Design: Cross-sectional observational study via web-based survey.

Setting: PICUs at North American academic institutions.

Subjects: Pediatric intensivists, pediatric critical care fellows, and pediatric residents.

Interventions: None.

Measurements and Main Results: A total of 1,323 responses were received representing a center response rate of 74% (147 of 200). Ninety percent of respondents stated that in-hospital coverage is good for patient care, and 85% stated that in-hospital coverage provides safer care. Sixty-three percent of intensivists stated that working in in-hospital models limits academic productivity, and 65% stated that in-hospital models interfere with nonclinical responsibilities. When compared with intensivists in home coverage models, intensivists working in in-hospital models generally had more favorable perceptions of the effects of in-hospital on patient care (p < 0.0001) and faculty quality of life. Physician burnout was measured with the abbreviated Maslach Burnout Inventory. Although 57% of intensivists responded that working in in-hospital models increases burnout risk, burnout scores were not different between coverage models. Seventy-nine percent of intensivists currently working at institutions with in-hospital coverage stated that they would prefer to work in an in-hospital coverage model, compared with 31% of those working in a home coverage model (p < 0.0001).

Conclusions: Although concerns exist regarding the effect of 24/7 in-hospital coverage on faculty, the majority of pediatric intensivists and critical care trainees responded that in-hospital coverage by intensivists is good for patient care. The majority of intensivists also state that they would prefer to work at an institution with in-hospital coverage. Further research is needed to objectively delineate the effects of in-hospital coverage on both patients and faculty.

©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies


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