Figure 2.

Framework and timeline of the study. The clinical quality improvement study occurred in three phases: 1) development of the intervention (escalation-of-care [EoC] protocol), 2) implementation of the intervention, and 3) dissemination of the intervention. The EoC protocol was developed over the course of six months. The initial implementation involved distributing educational materials to interns and supervising physicians over the course of one month, three months after which delayed dissemination or scale-up to all residents and nursing staff occurred over the course of one month.