Physician performance improves with experience and training. PICU performance may also reflect the physician staff's training. We hypothesized that severity and diagnosis adjusted PICU mortality in PICUs staffied by critical care fellows would be better than those with only pediatric residents.

Methods: Consecutive admissions to 8 PICUs with critical care fellows and 8 without (all volunteer with intensivists) were studied. Severity (PRISM) and diagnosis adjusted mortality risks were computed using a predictor developed in an independent sample. Evaluations of PICU-level performance used Standardized Mortality Ratios (SMRs) and patient-level analyses used logistic regression analysis. Monitoring and therapeutic modalities were compared with severity-adjusted odds ratios.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account
Continue with Google
Continue with ORCiD