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Workforce demographics and unit structure in paediatric cardiac critical care in the United States

Published online by Cambridge University Press:  03 December 2021

Robin V. Horak*
Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Anesthesia Critical Care, Children’s Hospital Los Angeles, Los Angeles, CA, USA
Shasha Bai
Biostatistics Resource at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
Bradley S. Marino
Department of Pediatrics, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland Clinic Children’s, Cleveland, OH, USA
David K. Werho
Department of Pediatrics, University of California San Diego School of Medicine, Rady Children’s Hospital, San Diego, CA, USA
Leslie A. Rhodes
Department of Pediatrics, University of Alabama at Birmingham, Children’s Hospital of Alabama, Birmingham, AL, USA
John M. Costello
Department of Pediatrics, Medical University of South Carolina College of Medicine, MUSC Shawn Jenkins Children’s Hospital, Charleston, SC, USA
Antonio G. Cabrera
Department of Pediatrics, University of Utah College of Medicine, The Heart Center, Intermountain Primary Children’s Hospital, Salt Lake City, UT, USA
David S. Cooper
Department of Pediatrics, University of Cincinnati College of Medicine, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Yubo Tan
Biostatistics Resource at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
Sarah Tabbutt
Department of Pediatrics, University of California San Francisco School of Medicine, Benioff Children’s Hospital, San Francisco, CA, USA
Catherine D. Krawczeski
Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children’s Hospital, Columbus, OH, USA
Author for correspondence: R. Horak, MD, Department of Anesthesiology, Critical Care Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd. MS #3, Los Angeles, CA90027, USA. Tel: 323-361-8202; Fax: 323-361-1001. E-mail:



To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States.


REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure.

Measurements and main results:

Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%).


Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

Original Article
© The Author(s), 2021. Published by Cambridge University Press

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