METHODS: A multi-disciplinary team developed an EM protocol that was implemented at the Parkland MICU in January 2015. Therapists with the experience, knowledge, and interest in performing EM within the MICU population were selected to become dedicated MICU therapists. This was in comparison to the historical model of circulating therapists throughout the various hospital wards depending on general staffing needs. To rapidly identify appropriate EM candidates, the EM therapist led a brief morning rounds with the MICU charge nurse, bedside nurses, and respiratory therapists. Therapy referrals were then placed if the primary treating physician agreed with the lead therapist’s assessment. This referral system was in contrast to the prior model of physician only referral decision making. We collected data 6 months pre and post intervention. We collected data on the number and appropriateness of referrals, complete versus incomplete treatment sessions, time to first therapy session, and MICU length of stay. We also used the relational coordination scale to assess the quality of teamwork amongst therapists and nurses.