Elmhurst Hospital Center · Emergency Medicine

Emergency Department Critical Care Delivery

A National Survey

⏱ 6-9 minutesOne response per site

DRAFT v0.10 · PILOT MODE. Responses are recorded and tagged pilot; pilot responses are excluded from the final dataset. Your progress is saved in this browser as you go.

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This survey characterizes the landscape of emergency department critical care delivery models across the United States and internationally. Results will be used to describe the prevalence, structure, and staffing of dedicated ED critical care resources.

If you are familiar with multiple sites, you are welcome to submit a separate response for each site.

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Section 1 Respondent & Institution

1. Your name (optional)

2. Your role at this site

Attending physician Fellow Resident Advanced practice provider Nursing Administrator / director Other:

3. Institution name

4. Hospital type

Academic medical center / university hospital Public / government (city, county, state, hospital district) Private, not-for-profit Private, for-profit Federal (VA, military, Indian Health Service) Other:

5. Emergency Medicine residency status

Primary EM residency training site EM residents rotate here, but this is not their primary site No EM residents

5a. Do residents or fellows from other specialties rotate through your ED?

Yes No

6. Location

Region is assigned at analysis, so it is not asked directly.

Country:

State or territory:

7. Approximate annual ED volume

< 30,000 visits/year 30,000-60,000 60,001-90,000 90,001-120,000 >120,000 visits/year Unknown

8. Number of ED treatment spaces (total beds/bays where patients are cared for; best guess is fine)

Section 2 How Critical Care Is Delivered in Your ED

9. Beyond standard ED care, does your ED have any dedicated resource for the care of critically ill patients? Examples: dedicated space, dedicated staff, or a dedicated team.

Yes No

Questions 10-16 describe ONE dedicated arrangement. If your ED has more than one distinct arrangement (for example, a resuscitation bay AND a consult service), you can describe a second one afterward.

17. Does your ED have a second distinct arrangement for critically ill patients?

Yes No

17a. (Second arrangement only) Is the second arrangement staffed by the same team as the one described in Questions 10-16?

Yes No

Section 3 Unit Characteristics

Answer this section for ONE arrangement. If more than one arrangement has dedicated space, answer for the unit with the most comprehensive critical care capabilities (e.g., bed count, nursing, physician staffing, longitudinal care).

18. In what year was this space/unit established?

Unknown

19. Number of dedicated beds

Answer for the unit as a whole, including any step-down or lower-acuity tier within it. Question 23 asks separately whether such a tier exists, its bed count, and who covers it.

20. Approximate number of patients cared for in this space per year

Unknown

21. Trainees and advanced practice providers in this space (typical daytime/peak)

How many trainees and/or APPs are typically present at one time? (enter 0 if none)

Which roles fill those positions? Select all that apply, including every role that may fill them, whether or not they are all present at the same time.

EM residents Residents from other specialties Fellows Advanced practice providers

22. Who writes orders and performs procedures for patients physically in this space, BEFORE the admission order? (select all that apply; check more than one if coverage differs by time of day)

ED team (covering other areas of the ED as well, not assigned only to this space) Dedicated team based primarily in this space EM critical care consult service ICU, inpatient critical care consult service, or inpatient primary service

22a. Who writes orders and performs procedures for ICU-bound patients physically in this space, AFTER the admission order (boarding)? (select all that apply; check more than one if coverage differs by time of day)

22b. What happens to patients admitted to a non-ICU (ward or telemetry) bed from this space?

They remain in this space, managed by the same team They remain in this space, managed by the inpatient service They remain in this space, co-managed by both teams They are moved out of this space (downgraded to the main ED or transferred to the floor) Not applicable, this space does not care for non-ICU bound patients

23. Does the ED include a step-down area?

Step-down: a distinct lower-acuity tier, still continuously monitored, for patients who no longer require the highest level of critical care but are not ready for a general ED or inpatient floor bed.

Yes No

Number of step-down beds:

23a. Were these beds counted as part of the critical care area’s total bed count (Question 19)?

Yes No

23b. Is the step-down area covered by the same physician(s) as the highest-acuity area?

Yes, same physician(s) No, separate coverage

Section 4 Staffing

Answer this section if any arrangement above has dedicated physician coverage.

24. Who primarily provides attending-level coverage? (select all that apply)

EM attendings without additional critical care training EM attendings with non-ABMS resuscitation/emergency critical care fellowship training (e.g., ECCR) EM attendings board-certified in Critical Care Medicine (IM, anesthesia, or surgery pathway) Critical care attendings from another specialty (intensivists, pulmonologists, etc.) Other:

25. How many fellowship-trained critical care physicians (any pathway) are in your ED faculty group?

26. Are fellows from any training program involved in coverage? (select all that apply)

Yes; ECC/resuscitation fellows Yes; Pulmonary/Critical Care fellows Yes; other: No

27. Which ancillary services routinely provide coverage to this space? (select all that apply)

Clinical pharmacist Respiratory therapy Critical care nursing educator Social work / case management Chaplaincy / palliative care None of the above

Section 5 Sites Without a Dedicated Unit or Team Beyond Resuscitation Bays

Answer this section only if you answered No to Question 9, or every arrangement you described self-classified as a Resuscitation Bay/Room.

28. What are the primary reasons your ED does not have a dedicated critical care unit or team beyond standard resuscitation bays? (select all that apply)

Insufficient physical space Insufficient staffing or personnel Lack of institutional or administrative support Insufficient patient volume to justify a dedicated unit or team Financial constraints No perceived need Model was previously in place but discontinued Other:

29. Is your department interested in developing a dedicated critical care unit or team beyond standard resuscitation bays in the future?

Yes, actively planning Yes, interested but no concrete plans Uncertain No

30. What would be the single greatest barrier to developing one at your institution?

Section 6 History & Context

31. Has your department’s critical care delivery model changed in the past 5 years?

Yes; expanded (added beds, extended hours, added dedicated staffing) Yes; reduced (lost beds, reduced hours, lost dedicated staffing) Yes; restructured (different model type) No significant change Not applicable / arrangement < 5 years old

32. Are you aware of other sites within your health system or training program that have a dedicated ED critical care resource?

Yes No

Please list:

Closing Almost done

33. Is there anything about your department’s critical care model that the above questions did not capture? (optional)

34. Would you be willing to be contacted for follow-up questions?

Yes No

Email:

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EHC Emergency Department

Emergency Medicine and Critical Care

ED Critical Care Delivery Survey (DRAFT v0.10)

Emergency Department Critical Care Delivery

Section 1 Respondent & Institution

Section 2 How Critical Care Is Delivered in Your ED

Section 3 Unit Characteristics

Section 4 Staffing

Section 5 Sites Without a Dedicated Unit or Team Beyond Resuscitation Bays

Section 6 History & Context

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