A recent New England Journal of Medicine article suggests perhaps less is better in the Intensive Care Unit (ICU). This came from the June 6, 2013 publication.
The article analyzes the effectiveness of having a night-time ICU specialist in attendance during the night shift. This study is relevant because there is an increasing trend of adopting the practice of nighttime physicians as part of the hospital team.
This was a one-year randomized trial in an academic center. The primary outcome was length of stay in the hospital and secondary outcomes included in-hospital mortality, discharge disposition, and recent readmission to the intensive care unit.
Despite the nighttime physician patient’s being seen 100% of the night’s versus 0% in the control group which did not have on-site nighttime physicians in attendance there was no statistical difference in the 2 different care models.
Bottom-line: This study suggests no benefit to hiring a nighttime doctor to see patients in the intensive care unit. The cost and resource utilization implications of this information is dramatic. In this case, less care appears to be better