The purpose of this study is to determine the association of a novel ED-based ICU, the Emergency Critical Care Center (EC3), with 30-day mortality and inpatient ICU admission.

In this cohort study of 349,310 patient encounters in the ED of an academic medical center, implementation of an ED-based ICU was associated with reductions in risk-adjusted 30-day mortality among ED patients, from 2.13% to 1.83%, and ICU admissions, from 3.2% to 2.7% of all ED visits. The study used electronic health records of all ED visits between September 1, 2012, and July 31, 2017, with a documented clinician encounter at a large academic medical center in the United States with approximately 75 000 adult ED visits per year.

Implementation of a novel ED-based ICU was associated with decreased risk-adjusted mortality and inpatient ICU admission rates among ED patients. Additional research is warranted to determine the value of this novel care delivery model in other health care systems. If translatable to other systems, this model may be an effective strategy to address the challenge of increasing demand for critical care delivery that is exceeding ICU capacity in the US healthcare system.

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