# Optimizing ED to ICU triage decisions for critically ill patients in respiratory distress

> **NIH NIH K23** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2021 · $74,188

## Abstract

PROJECT SUMMARY
The goal of the proposed research and career development plan is for the Principal Investigator (PI) to become
an independent clinical investigator using multiple research methods to directly improve the quality of care for
critically ill patients at the interface between the Emergency Department (ED) and Intensive Care Unit (ICU).
To transition into the next phase of her career and build upon her strengths as a critical care physician and her
prior training in clinical investigation and quantitative analysis, the PI will learn advanced research skills
through individualized and classroom training, including multi-level modeling, qualitative and mixed methods
approaches, decision analysis, and clinical decision support tool development. Triage decisions around ICU
admission for ED patients have profound implications for patient outcomes and utilization of ED and ICU
resources. Variation in this decision exists beyond what is explained by patient-related factors and bed
availability. The proposed K23 research seeks to improve access to appropriate ICU care and develop
innovative clinical solutions to reduce mortality by understanding the interaction between subjective and
objective factors on triage decision-making at the ED-ICU interface. The specific aims of this proposal are (1)
Examine the extent of variation in current ICU triage practice in an existing multi-hospital dataset of critically ill
ED patients with respiratory distress, using a mixed methods approach and multi-level modeling, (2) Identify
factors influencing subjective assessments of illness severity and likelihood to benefit from ICU admission,
using semi-structured physician interviews with scenarios developed from dataset analysis, and 3) Develop
and test the feasibility of an electronic health record-based clinical decision support tool to reduce potentially
harmful variation in ICU admission decisions. These aims have the potential to 1) identify disparities in triage
decisions for patients with certain characteristics when resources are limited, 2) provide insight into which
factors most affect physician triage practices as well as their perceptions of acuity and likelihood to benefit, and
3) pinpoint target areas for intervention using clinical decision support tools to improve care at the ED-ICU
interface.

## Key facts

- **NIH application ID:** 10393389
- **Project number:** 3K23HL130648-04S1
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Kusum Sara Mathews
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $74,188
- **Award type:** 3
- **Project period:** 2016-05-05 → 2022-01-09

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10393389

## Citation

> US National Institutes of Health, RePORTER application 10393389, Optimizing ED to ICU triage decisions for critically ill patients in respiratory distress (3K23HL130648-04S1). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10393389. Licensed CC0.

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