Randomization and Patient Characteristics

All patients admitted to the CICU and MICU were eligible for this trial, and there were no exclusion criteria. Patients were approached by our staff to provide informed consent. These patients were all 18 years and older and almost always required advanced supportive medications and devices. In contrast to the MICU, approximately 65% of patients admitted to the CICU presented with primary cardiac diagnoses, such as acute coronary syndrome or cardiogenic shock. The remaining 35% presented with similar diagnoses as the MICU patients but were located in the CICU due to lack of bed availability in the MICU. At admission, a computer-based randomizer algorithm assigned patients in each ICU to the control or intervention group. Patients had the opportunity to decline participation at any time, in which case they would continue to receive usual ICU care but were excluded from the study population.