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Should hospitals have intensivist consultants in-house 24 hours a day? - Yes

Sean L Kelly, Roger D Harris and Anthony R Burrell
Med J Aust 2013; 198 (6): 308. || doi: 10.5694/mja12.11578
Published online: 1 April 2013

Onsite intensivist support is needed to improve clinical decisions and safety

An intensive care unit (ICU) is only as good as the care and decision making provided at 2 am. If we believe that intensivists really make a difference to patient outcomes, surely extended hours of onsite intensivist cover are necessary? A patient-centred approach to staffing that takes into account the potential for human error is needed. Most Australian ICUs are staffed after-hours by registrars. Some are not vocational trainees. Experience and clinical skill is variable. Onsite intensivist support tends to be concentrated throughout the day, with the on-call specialists often required to be onsite for 12 hours or more and on-call overnight. Challenges exist in providing uniform levels of clinical expertise around the clock to ICU patients while maintaining a healthy and safe work routine for clinicians.

  • Sean L Kelly1,2
  • Roger D Harris3,4
  • Anthony R Burrell1,5

  • 1 Intensive Care Coordination and Monitoring Unit, Agency for Clinical Innovation, Sydney, NSW.
  • 2 Faculty of Health, University of Newcastle, Newcastle, NSW.
  • 3 Royal North Shore Hospital, Sydney, NSW.
  • 4 University of Sydney, Sydney, NSW.
  • 5 University of Technology, Sydney, NSW.


Competing interests:

No relevant disclosures.

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