Nighttime physician staffing improves patient outcomes: No

There is tremendous conceptual validity and a preponderance of evidence to suggest that being cared for by a critical care specialist (intensivist) is “good” for ICU patients. Similarly, there are strong reasons to suspect, and some data to support, that outcomes are worse for ICU patients admitted during “off” hours. Thus, it is a reasonable extrapolation that having intensivists staff ICUs at night would improve patient outcomes. If some exposure to intensivists is good, it stands to reason that more exposure would be better. This essay argues that despite the good sense of these premises, there is sufficient evidence to forcefully conclude that nighttime intensivist staffing does not promote improved patient survival, length of stay, or other standard clinical outcomes.

National Heart, Lung, and Blood Institute