A Collaborative ICU Staffing Model: A Model Comprised of Nurse Practitioners and Physician

The aging population and advanced medical therapies has contributed to an increased need for more onsite medical coverage in Intensive Care Units (ICU) across the country. However, there has been a shortage of adequately trained critical care provider to staff these ICUs. This has contributed to current critical care providers being overworked, leading to provider burnout and provider turnover. Inadequate coverage in the ICU has contributed to inadequate medical care, compromise patient safety, loss of revenue for the hospital, and finally a decrease in provider, nursing staff, and patient satisfaction. The purpose of the project was to assess current provider coverage in a local ICU, determine future needs based on current admission rates and patient acuities, and propose a collaborative staffing model comprised of both physicians and nurse practitioners. The collaborative staffing model was formulated after a review of current literature and assessment of other area ICU staffing models. Finally, the proposed staffing model was presented to the key stakeholders for review and comments. This project had four objectives: 1) Collect and assess current local intensive care unit staffing levels and models. 2) Compare local findings with current research and identify potential barriers. 3) Propose a collaborative provider staffing model incorporating current research and current ICU needs. 4) Present and disseminate the proposed staffing model to stakeholders and submit an abstract to a local conference's poster presentation. Based on the literature review, there is a growing need for provider coverage in most ICUs across the country. Most hospitals are experiencing an increased in patient acuity and ICU admission rates. There is currently a nationwide shortage of critical care providers due to stagnant levels of new critical care providers and increases in both turnover and burnout rates. Critical care provider staffing models that include nurse practitioners have been successful in many ICUs nationwide. Billing for ICUs using a nurse practitioner/physician model has not been disrupted or found to decrease potential revenue. Also the physician/nurse practitioner model has shown to improve medical care in the ICU by providing consistency in the medical care provided, and increased in both patient and medical staff satisfaction levels. Results from the project indicate that units were potentially understaffed based on the highest potential patient to provider ratio. However, the assessment of one particular unit was identified as facing a critical provider shortage. These results supported the need for a change in provider coverage in order to meet the current trend of increasing patient acuity and increasing admissions rates. Based on these findings a collaborative staffing model comprised of both physician and nurse practitioner providers was proposed to the administrative team of this facility for their consideration.