Table 5.

Manpower strategies to maintain critical care staffing requirements

Staffing	Potential manpower sources and measures
Physician	Redeploy specialists with formal ICU training and accreditation, but not currently working in critical care units such as anaesthetists and pulmonologists into ICUs.
	Anaesthetists without formal critical care accreditation but recent, substantial critical care experience may take certain supervisory and leadership roles in the ICU under supervision by an accredited intensivist.
	Anaesthetists without formal critical care accreditation and no recent critical care experience may assist in ICU care at registrar level.
	Redeploy anaesthesia and medical registrars and trainees with critical care experience and training to ICUs and HDUs, especially with a reduction in surgical load.
	Junior physicians from other disciplines with critical care or ICU exposure as part of their training programme such as general surgical trainees who can assist in administrative duties and basic ICU‐related care under direct supervision of an intensivist.
	Step‐down of specialist physicians of other disciplines and surgeons to assist in ICU* and HDU duties in appropriate capacities.
Nursing	Redeploy nursing staff with prior critical care training and experience, but not currently working in critical care areas.
	Redeploy nursing staff currently working in HDUs into ICUs.
	Nurses from surgical units such as anaesthetic and recovery nurses who are familiar with a critical care environment and advanced physiological monitoring, may be deployed into ICUs and HDUs.
	Nurses from other backgrounds such as outpatient clinics, which will see an anticipated drop in case load can be redeployed into general wards or HDUs.
	Agency nurses not part of the hospital permanent nursing staff can assist in general wards.
General	Redeployment of manpower from wards and clinics.
	Reduce during office hours manpower with a reduction in non‐essential services, and conversion to a shift‐work system.
	Conversion to longer shifts (e.g. 8–12‐h shifts), and accept a reduced staffing relief factor.
	Recall of medical staff on overseas training programmes.
	Recall of staff on pre‐approved annual leave.
	Utilisation of retired staff with valid certifications, and preferably recent experience.
	Utilisation of personnel in administrative roles such as research or education.
	Consider redeploying personnel currently in private practice or other agencies into public health institutions.

ICU, intensive care unit; HDU, high dependency unit.