Critical Care

The EC3 model has demonstrated substantial improvements in emergency department critical care delivery. The model significantly optimized resource utilization, with 75% of minor intracranial hemorrhage patients no longer requiring ICU admission and 60% of EC3 patients being downgraded from critical to general care. 

For time-sensitive conditions requiring prolonged critical care including mechanical ventilation, oncologic emergencies, and GI bleeding, EC3 improved both clinical outcomes and reduced hospital length of stay. The model achieved median time to ICU-level care of 3.4 hours compared to 5.3 hours previously, with 19% more patients receiving critical care within the crucial 6-hour window. Remarkably, EC3 maintained cost neutrality while delivering these quality improvements, with no increase in direct costs per encounter despite managing higher-acuity patients, resulting in a 46.6% increase in direct margin per encounter. Overall, EC3 is estimated to have saved over 2,200 additional lives over its first decade of operation. 

• Medical Students: We do not currently offer an EC3-only visiting medical student elective. However, visiting students are welcome to apply to the EM elective and may express interest in EC3-focused shifts during their rotation. 

• Residency: We host a four-year emergency medicine residency. Residents work in EC3 longitudinally throughout their training, benefiting from the unique opportunity to observe changes in physiology and perform advanced procedures that arise during the first 12-24 hours of resuscitation of patients with critical illness, and are a core asset to EC3.  

• Fellowship: We offer two-year pathways to board certification for emergency medicine trained physicians through the internal medicine pathway and the anesthesiology pathway. Critical care fellows from both the internal medicine and anesthesiology pathways rotate through EC3. We are often able to host fellows from other University of Michigan programs with enough advance notice. We do not currently offer observerships. 

Our division leads a highly collaborative, innovative research portfolio spanning basic science, translational research, clinical studies, and health services research at the forefront of emergency critical care. Faculty and trainees work alongside dedicated clinical research coordinators, data analysts, statisticians, and a study design team empowering rigorous investigations into some of the most urgent challenges in acute care. Funding from the NIH, AHA, DoD, philanthropy, and other major sponsors fuel our diverse research portfolio.  

Our research brings together multidisciplinary teams across emergency medicine, intensive care, surgery, data science, engineering, and more. Partnerships with the Weil Institute for Critical Care Research and Innovation, SIREN, and the CTSU cultivate cross-campus initiatives to develop and test novel therapies and technologies. Through the Division of Critical Care and the Department of Emergency Medicine’s commitment to research and innovation, we are working to transform care for critically ill patients.