Fig. 1

Study flow diagram. The included patients are 16 years or older. They were enrolled in the JIPAD between April 2015 and March 2021 and were admitted immediately to the ICU or the next day after hospital admission. The exclusion criteria applied to facilities missing ICU staff data, patients lacking JROD scores, and facilities with fewer than 10 qualifying patients annually among their patients. JIPAD Japanese Intensive Care PAtient Database, ICU intensive care unit, JROD Japan Risk of Death