title: Survey of in-house coverage by pediatric intensivists: characterization of 24/7 in-hospital pediatric critical care faculty coverage*.
abstract: OBJECTIVE
  To characterize the current state of 24/7 in-hospital pediatric intensivist coverage in academic PICUs, including perceptions of faculty and trainees regarding the advantages and disadvantages of in-hospital coverage.
  
  
  METHODS
  Cross-sectional observational study via web-based survey.
  
  
  METHODS
  PICUs at North American academic institutions.
  
  
  METHODS
  Pediatric intensivists, pediatric critical care fellows, and pediatric residents.
  
  
  METHODS
  None.
  
  
  RESULTS
  A total of 1,323 responses were received representing a center response rate of 74% (147 of 200). Ninety percent of respondents stated that in-hospital coverage is good for patient care, and 85% stated that in-hospital coverage provides safer care. Sixty-three percent of intensivists stated that working in in-hospital models limits academic productivity, and 65% stated that in-hospital models interfere with nonclinical responsibilities. When compared with intensivists in home coverage models, intensivists working in in-hospital models generally had more favorable perceptions of the effects of in-hospital on patient care (p < 0.0001) and faculty quality of life. Physician burnout was measured with the abbreviated Maslach Burnout Inventory. Although 57% of intensivists responded that working in in-hospital models increases burnout risk, burnout scores were not different between coverage models. Seventy-nine percent of intensivists currently working at institutions with in-hospital coverage stated that they would prefer to work in an in-hospital coverage model, compared with 31% of those working in a home coverage model (p < 0.0001).
  
  
  CONCLUSIONS
  Although concerns exist regarding the effect of 24/7 in-hospital coverage on faculty, the majority of pediatric intensivists and critical care trainees responded that in-hospital coverage by intensivists is good for patient care. The majority of intensivists also state that they would prefer to work at an institution with in-hospital coverage. Further research is needed to objectively delineate the effects of in-hospital coverage on both patients and faculty.
authors.affiliation: 1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, NC. 2Division of Critical Care Medicine, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Rehder
authors.forename: Ira M
authors.initials: IM
authors.lastname: Cheifetz
authors.forename: Barry P
authors.initials: BP
authors.lastname: Markovitz
authors.forename: David A
authors.initials: DA
authors.lastname: Turner
mesh_terms: D002055:Burnout, Professional / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D003422:Critical Care / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005178:Faculty / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D009656:North America; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D010820:Physicians; D011795:Surveys and Questionnaires; D016526:Workload / Q000706:statistics & numerical data*