Presentation delivered at the second annual William G. Barsan Emergency Medicine Research Forum, Ann Arbor, April 12, 2017.

1. Benjamin Bassin MD
Director of Critical Care Operations
Associate Service Chief
Department of Emergency Medicine
University of Michigan Health System

2.  None

4. Grand opening February 16, 2015

5. Pre-EC3
(744d)
Post-EC3
(744d)
Relative
Change
Overall EDVisits 147,030 157,190 6.9%
Hospital Admissions 51,451 55,912 8.7%
ICU Admissions 3,742 3,279 -12.4%

6. Total ED
Visits
ICU
Admission
ICU
Admission
Rate
95% CI
Pre-EC3 147,030 3,742 2.54% 2.47-2.63%
Post-EC3 157,190 3,279 2.08% 2.02-2.16%
Relative Risk Reduction = 18% [95%CI:14-22%]
Number Needed To Treat = 218 [95%CI:177-284]

7.  Average 7 patients per day
 Median EC3 LOS ICU admit = 7.2 hr
 Median EC3 LOS Non-ICU admit = 12 hr
BiPap/Intubation/Vent 595 11.5%
DKA 276 5.3%
End of Life 61 1.2%
GI Bleed 421 8.1%
Post Cardiac Arrest 84 1.6%
Sepsis 794 15.4%
Shortness of Breath 514 9.9%
Status Epilepticus 57 1.1%
Subarachnoid Hemorrhage 133 2.6%
Undifferentiated 2,546 49.2%
Unknown 391 7.6%
EC3 Pathway
Multiple per patient possible Count %

8.  Retrospective Analysis of De-identified Databases Derived from
Emergency Department and Critical Care Quality Improvement and
Patient Safety Projects
 REP00000004
 PI: Dr. Glazer
 Co-I: Drs. Bassin, Gunnerson, Medlin, Neumar
 Protocol for creating repository of de-identified data from EM and CC
QI/PS projects previously exempted for research analysis and publication

9.  Risk-Adjusted Outcome Prediction Tool for Emergency Department
Intensive Care Unit Patients
 HUM00100918
 Discovery Award as part of the Joint Institute (JI) for Translational and Clinical
Research
 PI: Dr. Gunnerson
 Co-I: Drs. Bassin, Glazer, Medlin and Neumar
 Analyzing effectiveness of existing ED and ICU scoring systems in
predicting 7-day and 30-day mortality
 DAVROS, SAPS3
 Develop and validate novel Emergency-ICU Risk Adjustment Score (EIRAS)

10.  Glazer JM, Medlin RP, Bassin BS, Ward KR, Neumar RW, Gunnerson KJ:
Existing Disease Severity Scoring Systems and Their Utility in an ED-ICU
(Oral Presentation) Society of Critical Care Medicine, Honolulu, HI, Critical
Care Medicine 44, 356, 2017.
 Glazer JM, Gunnerson KJ, Medlin RP, Bassin BS, Ward KR, Neumar RW Ma
Q, Su W, Ge HX, Liang Y, Li N, Zheng Y: Risk Adjusted Outcome Prediction
of Emergency Department Intensive Care Unit Patients (Poster
Presentation), Peking University Health Science Center/University of
Michigan Health System Joint Institute Symposium, Ann Arbor, MI, 2016.
 Manuscript in final stages of development

11.  Sozener CB, Bassin BS, Gunnerson KG, Havey RA, Gegenheimer-Holmes J,
Neumar RW.: Building an ED-Based ICU: A Lean Journey (Oral
Presentation), SAEM Annual Meeting, New Orleans, LA, Academic
Emergency Medicine, 23, Suppl. 1, S288, 2016.
 Bassin BS, Sozener CB. Building an Emergency Critical Care Center (EC3): A
Lean Journey, Center for Healthcare Design Pebble in Practice Workshop:
The Emergency Department - Considerations for Innovative and Strategic
Design, June 2015, San Francisco, CA
 Sozener CB, Bassin BS. The LEAN ED: Designs to Optimize Longevity and
Relevance, Healthcare Design National Conference, November 2015,
Washington DC

12.  Management and Outcomes of DKA in the Adult Emergency Department
and EC3
 HUM00106910
 PI: Dr. Whitmore
 Co-I: Drs. Haas, Ganti, Hapner, Bassin and Gunnerson
 Stay Tuned…

13.  Haas N, Gunnerson K, Ganti A, Boyd C, Cranford J, Hauser S, Whitmore S. Safety and
Outcomes of a “Two¬Bag” System for Management of DKA in Adults. Society of Critical
Care Medicine Critical Care Congress, January 22, 2017, Honolulu, Hawaii.
 Haas N, Ganti A, Hapner C, Bassin B, Gunnerson K, Whitmore S. An Emergency
Department-Based Intensive Care Unit Decreases Hospital and ICU Utilization in
Diabetic Ketoacidosis. SAEM Annual Meeting, May 13, 2016, New Orleans, LA.
 Haas N, Ganti A, Hapner C, Bassin B, Gunnerson K, Whitmore S. An Emergency
Department-Based Intensive Care Unit Decreases Hospital and ICU Utilization in
Diabetic Ketoacidosis. William G Barsan Emergency Medicine Research Forum, April
27, 2016, Ann Arbor, MI.
 Haas N, Ganti A, Hapner C, Bassin B, Gunnerson K, Whitmore S. An Emergency
Department-Based Intensive Care Unit Decreases Hospital and ICU Utilization in
Diabetic Ketoacidosis. EMRAM Research Forum, April 19, 2016, Saginaw, MI.
 Two manuscripts nearing submission

14.  The Impact of an Emergency Department-Based Critical Care Unit on the
Procedural Training Experience for Residents
 Co-PI: Drs. Stull, Hopson and Heideman
 Co-I: Drs. Tehranisa, Hartley, Bassin and Gunnerson
 Stull MJ, Hopson LR, Bassin BS, Heidemann L, Hartley S, Tochman S,
Gunnerson KJ.: The Impact of an Emergency Department-Based Critical Care
Unit on the Procedural Training Experience for Residents (Poster
Presentation), Council of Emergency Medicine Residency Directors 2016
Academic Assembly, Nashville, TN, 2016.
 Heideman L, Stull M, Hopson LR, Bassin BS, Gunnerson KJ, Tochman S, Hartley
S. The Impact of a Novel Emergency Department Intensive Care Unit on
Trainees Critical Care Experience (Poster Presentation), Society of Hospital
Medicine Annual Meeting, San Diego, CA, Journal of Hospital Medicine (11)
Suppl. 1, 2016

15.  Development of an ED-Based Palliative Care Protocol
 HUM00107262
 PI: Dr. Harvey
 Co-I: Renee Havey RN MSN, Drs. Bassin, Gunnerson, Kessler, Litell and
Whitmore
 Harvey C, Gunnerson K, Kessler R, Litell J, Whitmore S, Havey R, Bassin BS.
The Impact of an ED-Based Critical Care Unit on the Provision of Palliative
Care in the Emergency Department (Poster Presentation), SAEM Annual
Meeting, New Orleans, LA, Academic Emergency Medicine, 23, Suppl. 1,
S235-236, 2016.
 Harvey C. The Impact of an ED-Based Critical Care Unit on Early Palliative
Medicine Interventions (Poster Presentation), SMACC, Dublin Ireland,
June 2016.

16.  Emergency Critical Care Management of Intoxicated and Overdose
Patients
 HUM00107490
 PI: Dr. Otero
 Co-I: Drs. Sozener, Bassin, Gunnerson, Ben Long M3 and Jim Cranford
 Otero RM, Long B, Sozener CB, Bassin BS, Gunnerson KG, Cranford J.:
Impact of an Emergency Critical Care Unit on the Disposition of Critically
Ill Toxicology Patients (Oral Presentation), Society of Critical Care
Medicine, Honolulu, HI, Critical Care Medicine, 44, 294, 2017
 Manuscript in progress

17.  Effect of ED-ICU Model on Utilization of Non-Invasive Ventilation
 HUM00108181
 PI: Renee Havey, RN, MSN
 Co-I: Cassie Holman RN, Drs. Glazer, Gunnerson and Bassin
 Havey RA, Holman C, Glazer J, Gunnerson KG, Bassin BS. The Effect of an
Emergency Department-Based Critical Care Unit on the Utilization of Non-
Invasive Positive Pressure Ventilation and Patient Disposition (Oral
Presentation), SAEM Annual Meeting, New Orleans, LA, Academic
Emergency Medicine, 23, Suppl. 1, S173, 2016.

18.  Havey, R., Aebersold, C., & Hauser, S. An Innovative Approach to Providing
Critical Care In the Emergency Department: Nursing's Journey to Deliver
Care in an ED-Based ICU (Oral Presentation). National Association of
Clinical Nurse Specialists Annual Conference, Atlanta GA, March 2017.
 Aebersold, C., Hauser, S,. & Havey, R. An Innovative Approach to Providing
Critical Care In the Emergency Department: Nursing's Journey to Deliver
Care in an ED-Based ICU (Poster Presentation). National Teaching
Institute, American Association of Critical Care Nurses, Houston TX,
August 2017.

19.  Prognosticate Resuscitation Demands Integrating Computational Triage
(PReDICT)

20.  HUM00105031
 Co-PI: Drs. Glazer and Bassin
 Co-I: Drs. Gunnerson, Kronick, Medlin, Neumar, Wiens and Jeeheh Oh
 Glazer JM, Gunnerson KJ, Medlin RP, Kronick SL, Neumar RW, Bassin BS.
PReDICT: Prognosticate Resuscitation Demands Integrating Computerized
Triage (Poster Presentation), SAEM Annual Meeting, New Orleans, LA,
Academic Emergency Medicine, 23, Suppl. 1, S237, 2016.
 Featured Presentation at EPIC Expert Group Meeting (XGM) May 2017

21.  “Impact of an Emergency Critical Care Unit on a University Based
Ultrasound Program”
 Drs. Betcher, Majkrzak, Cover, Kessler, Theyyunnni, Huang and Matthew
Chapman M3
 Scheduled for presentation at SAEM 2017 Annual Meeting
 “Defining and designing an evaluative tool for ultrasound competency in
pre-hospital providers”
 Drs. Micheller, Cover
 Scheduled for presentation at SAEM 2017 Annual Meeting
 “Perceived benefit of out-of-hospital critical care ultrasound performed
by pre-hospital providers”
 PI: Dr. Cover, Kessler, Theyyunni, Bassin and Chelsea Tafoya M4
 Scheduled for presentation at Western SAEM Regional Meeting

22.  Descriptive Analysis of Extracorporeal Cardiopulmonary Resuscitation
Following Out-of-Hospital Cardiac Arrest – An ELSO Registry Study
 Drs Haas, Coute, Hsu and Neumar
 Scheduled for presentation at SAEM 2017 Annual Meeting
 "Post-Cardiac Arrest Care"
 Drs. Stull, N Haas, M Haas, and Whitmore
 Will be published in the June issue of Critical Decisions in Emergency Medicine