Purpose of the study /Objective The purpose of this study is to audit impact of Anesthesiologist on patient outcomes, the objective of this study is to evaluate the impact of change in system of ICU patient's care on outcome. Background Abubakar Tafawa Balewa University Teaching Hospital since its establishment in 2010 operate two bed Intensive Care Unit (ICU). In 2017 following employment of consultant Anesthesiologist, the ICU care system was changed from open to semi-close Intensive Care System Methods Medical records of all consecutive patients admitted to the ICU from May 2016 to April 2017 (open system n = 76) and from May 2017 to April 2018 (Semi-close system n = 92) were reviewed. The variables studied were Mortality, ICU length of stay and incidence of acute kidney injury. Results Mortality was 56.6% in the open system group and 29.3% among the patients in the semi-close system group (p = 0.001). The length of ICU stay was 5.4±5 and 4.5± 4 days for open system and semi-close system groups respectively, while the incidence of acute kidney injury among the open system group was 44.7% and 12% among the patients in the semi-open system group (p =0.001). Conclusion Results from this study revealed that, semi-close system care of critically ill patients is associated with lower mortality.