Patients with acute respiratory failure requiring mechanical ventilation are at high risk for morbidity and mortality. Several landmark clinical trials have yielded evidence-based treatments to reduce mortality in mechanically ventilated patients, but these therapies have been unevenly adopted and patient outcomes remain highly variable. One potential source of variation in outcomes among ventilated patients is individual physician experience. However, it is unknown whether organizational solutions (e.g., multidisciplinary care models, non-physician-driven clinical protocols, and checklists) can change the relationship between physician experience and outcomes. The overall objective of this research is to define the relationship between individual physician experience and the outcomes of mechanically ventilated patients. This project will create a new database composed of multiple publicly available datasets linked to a statewide survey of hospital-level organizational factors. This will result in a novel cohort of mechanically ventilated patients with the capacity for case-mix adjustment, an algorithm to classify these patients and link them to their individual physicians, and robust information about their physicians' experience and the organizational solutions of their admitting hospitals.
National Heart, Lung, and Blood Institute