Association of an Emergency Critical Care Program With Survival and Early Downgrade Among Critically Ill Medical Patients in the Emergency Department

ObjectivesTo determine whether implementation of an Emergency Critical Care Program (ECCP) is associated with improved survival and early downgrade of critically ill medical patients in the emergency department (ED).DesignSingle-center, retrospective cohort study using ED-visit data between 2015 and 2019.SettingTertiary academic medical center.PatientsAdult medical patients presenting to the ED with a critical care admission order within 12 hours of arrival.InterventionsDedicated bedside critical care for medical ICU patients by an ED-based intensivist following initial resuscitation by the ED team.Measurements and main resultsPrimary outcomes were inhospital mortality and the proportion of patients downgraded to non-ICU status while in the ED within 6 hours of the critical care admission order (ED downgrade