The Michigan Health and Safety Coalition ICU Physician Staffing Guideline

The Michigan Health and Safety Coalition (MH&SC) Intensive Care Unit Physician Staffing Guideline was developed in 2001 and is designed to improve the safety and quality of patient care in all Michigan hospitals providing adult ICU care . Michigan hospitals with intensive care units evaluate their performance relative to the guideline through the MH&SC’s annual survey of hospitals.

The MH&SC ICU physician staffing guideline recognizes the important role intensivists and other appropriately qualified physicians have in increasing and maintaining the safety and quality of ICUs.

The MH&SC ICU guideline advises that intensive care units be managed by an intensivist, i.e., a physician certified (or eligible for certification) in critical care medicine who directs clinical care for the ICU where:

• Concurrent care by the primary attending, surgical or medical doctor is encouraged for all patients; and

• The intensivist monitors admission and discharge criteria, and implementation of care protocols.

The intent and ultimate goal of the MH&SC’s work related to ICU safety is to increase the number of Michigan hospitals that fully meet the ICU Staffing Guideline and adopt the model of ICU care endorsed by the MH&SC and other national organizations. The MH&SC recognizes that there are factors that make it difficult for some hospitals to fully adopt the endorsed model of ICU care at this time. Even so, this toolkit suggests transitional steps hospitals can take to move closer to meeting the guideline and adopting the endorsed model of care. Although adoption of the transitional steps in the absence of an intensivist to manage the ICU will not permit the hospital to fully meet the MH&SC guideline, the efforts will bring Michigan hospitals more in line with the recommended safety benchmarks.

© 2004 Michigan Health and Safety Coalition