Solving the Challenge of Off-Shift Intubations at a Community Hospital

Nighttime or off-shift intubations are a low-frequency, high-risk procedure in a community hospital with no anesthesia in-house and an inconsistent level of skill from our traditional in-house resident and hospitalist coverage. Solving the problem is complex and can be costly. Brigham and Women's Faulkner Hospital sought to design a safe, cost-effective, sustainable solution. The project takes place in a 150-bed hospital with a very active inpatient medical/surgical service. The challenge was to identify a safe, effective way to provide consistent off-hours intubations while continuing to provide safe coverage throughout the rest of the institution.