Team care: Beyond open and closed intensive care units

Peter J. Pronovost, Christine G. Holzmueller, Lia Clattenburg, Sean Berenholtz, Elizabeth A. Martinez, Jose Rodriguez Paz, Dale M. Needham

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations


PURPOSE OF REVIEW: Evidence supporting dedicated intensivist staffing in intensive care units is growing. Despite clinical and economic benefits, medical staff politics and a shortage of intensivists impede the intensivist model. The purpose of this paper is to accelerate patient's exposure to the benefits of intensivists, and introduce team care in the intensive care unit. RECENT FINDINGS: The cost savings achieved through intensivist staffing range from $510 000 to $3.3 million. The intensivist model may only have been adopted by 4% of intensive care units. Barriers to implementing the model are shortage of intensivists, reimbursement for intensivists, and political will. Four attributes make the model ideal: physical presence, knowledge of critical care practice, coordination of team care, and unit management. It may be helpful to not label intensive care units as open or closed and consider team care, whereby hospitals seek to achieve the attributes of the model given their resources and culture. SUMMARY: Intensivists save lives and costs. By working toward team care, hospitals may achieve a successful intensivist model, and patients may realize the benefits of spending less for healthcare and living longer. To achieve this model, physician and hospital leaders must form a partnership.

Original languageEnglish (US)
Pages (from-to)604-608
Number of pages5
JournalCurrent opinion in critical care
Issue number6
StatePublished - Dec 2006


  • Closed intensive care unit
  • Intensive care unit team care
  • Intensivist staffing

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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