Millions of patients with acute respiratory failure or sepsis present to US emergency departments each year. Rates of admission to intensive care units (ICUs) or hospital wards for patients not requiring life support can vary considerably both among hospitals and within hospitals over time due to bed availability. This mixed-methods study in 26 hospitals across the University of Pennsylvania and Kaiser Permanente of Northern California health systems will leverage among- and within-hospital practice variability to precisely characterize patients who benefit from ICU or ward admission and identify emergency department, ward, and ICU care processes that contribute to net ICU or ward benefits. Using granular electronic health record data, instrumental variable analyses, ethnography, and semi-structured interviews, our results will improve outcomes for these acutely ill patients by enabling personalized triage.
National Heart, Lung, and Blood Institute