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DELTA: Determinants of Effective Long Term Acute Care

PI: Jeremy Kahn, MD, MS

Co-Investigators: Derek Angus, MD, MPH, FRCP; Amber Barnato, MD, MPH, MS; Nicholas Castle, PhD

Funding: NIH R01HL096651

Many patients with critical illness experience persistent organ failures and prolonged mechanical ventilation, a syndrome known as “chronic critical illness.” Increasingly, patients with chronic critical illness receive care in long-term acute care hospitals (LTACHs), specialized facilities for the care of these high-risk, high-cost patients. In our prior work, we demonstrated that LTACHs play an important role in the care of chronic critical illness, producing similar outcomes at lower costs compared to traditional ICUs. Given the important role LTACHs play in the health system, there is now a pressing need for research on how to best organize and manage care within LTACHs in order to optimize care for patients with chronic critical illness.

To address this problem, we designed the DELTA study: Determinants of Effective Long Term Acute Care. The goal of DELTA to identify the key clinical and organizational factors associated with long-term acute care effectiveness. Using both qualitative and quantitative methods, DELTA will both identify a core set of LTACH “best practices.”

Funded by the National Institutes of Health, DELTA is the first rigorous examination of the factors that define high quality LTACHs. DELTA will provide clinicians, administrators and policy makers with immediate, actionable data about how to provide LTACH-style care most effectively and efficiently, leading to improved survival for patients with chronic critical illness.