ArticlePhysicians Leading Physicians A Physician Engagement Intervention Decreases Inappropriate Use of IICU Level of Care AccommodationsRuiz Colón, Gabriela AB1; Yang, Jingkun MD1; Svec, David MD, MBA1; Heidenreich, Paul MD, MS1; Britt, Patricia MSN, RN2; Smith, Margaret MBA3; Sharp, Christopher MD1; Shieh, Lisa MD, PhD1Author Information 1Stanford University, School of Medicine, Stanford, CA 2Patient Care Services, Stanford Health Care, Stanford, CA 3Healthcare AI Applied Research Team, Division of Primary Care and Population Health, Stanford Health Care, Stanford, CA Corresponding Author: Lisa Shieh, MD, PhD, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305. Email: [email protected] Online date: April 20, 2021 American Journal of Medical Quality: November/December 2021 - Volume 36 - Issue 6 - p 387-394 doi: 10.1097/01.JMQ.0000735480.43566.f9 Buy Metrics Abstract Following the adoption of an acuity-adaptable unit model in an academic medical center, a $13M increase in cost of intermediate intensive care unit (IICU) accommodations was observed. The authors followed A3 methodology to determine the root cause of this increase and developed a 3-prong intervention centered on physician engagement, given that physicians have the ability to order a patient’s level of care. This intervention consisted of: (1) identifying physician champions to promote appropriate IICU use, (2) visual changes to essential electronic medical record tools, and (3) data-driven feedback to physician champions. In the year following intervention deployment, average IICU length of stay decreased from 1.08 to 0.62 days and average IICU use decreased from 21.4% to 12.3%, corresponding to ~$5.7M cost savings with no significant change in balancing measures observed. Together, these results demonstrate that a multicomponent intervention aimed at engaging physicians reduced inappropriate IICU use with no increase in adverse events. Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.