Prizewinning KI research greatly increases survival for the critically ill
KI researchers Tim Baker and Carl Otto Schell have been awarded the Lancet’s Evidence to Impact Award for their efforts to increase the survival rate for critically ill patients. The concept they have developed is called Essential Emergency and Critical Care and comprises 40 basic treatments. In the first large implementation study, mortality decreased by 31 per cent. “We both want to make the world a better place,” they say.
Critical illness means that vital organs fail, causing serious problems with processes like blood supply and respiration. Swift intervention is needed if the patients are to survive. Nonetheless, Tim Baker, docent at KI’s Department of Global Public Health and his departmental colleague, researcher Carl Otto Schell, each separately made the same frustrating observation: inpatients at a hospital unit, following a hip joint operation for example, were not receiving help in time.
“People were unnecessarily dying in Swedish hospitals because the simplest life-saving interventions were not being done, such as making sure that unconscious people are lying on their side or promptly ventilating patients with oxygen deficiency,” says Dr Schell, senior physician at Nyköping Hospital and the Centre for Clinical Research, Sörmland.
Tim Baker had the same impression in the UK, Sweden and Tanzania, where he was a volunteer doctor for two years.
“Many patients who received the general care they needed weren’t getting these life-saving treatments,” he says, prompting Dr Schell to add:
“What we saw wasn’t noise, it was a clear signal – the system is not delivering this.”
The solution is not more IC beds
So how common is critical illness? Early in his doctoral studies, Carl Otto Schell probed the literature and found that there was a total lack of knowledge in this area: “It was completely bare”.
“Previous estimations of the number of critically ill have been based on intensive care figures, but this is far from the whole story.”
In a 2025 issue of The Lancet, they described the scale of the problem in 20,000 patients at 180 hospitals in 22 African countries: one in eight patients were critically ill, only 20 per cent of whom left the hospital alive.
In BMJ Global Health, they described the same scenario in three countries with diverse economies: Sweden, Sri Lanka and Malawi. In Sweden, one in ten inpatients were critically ill, of whom 18 per cent died while still in hospital.
In both studies, the vast majority of critically ill patients were in units other than intensive care.
“But the solution isn’t to create more IC places, it’s to make sure that patients throughout the hospital are given basic life-saving treatment,” says Dr Baker.
In order to study the question, they developed the concept Essential Emergency and Critical Care (EECC).
40 interventions that can save lives
The concept, which was described in BMJ Global Health in 2021, consists of 40 basic treatments that can be performed at a regular hospital unit. EECC requires all medical staff to be able to identify critical illness and provide basic care.
The first major implementation project took place in Tanzania and included 79 hospitals and clinics in six regions. At the hospitals where EECC had been implemented, mortality was 31 per cent lower three months afterwards than in the previous year.
“We should, however, exercise caution,” says Dr Baker. “This is a before-after study that reveals an association but not a causality. But the indications are that the treatments are effective.”
For example, the share of patients who needed and received EECC rose from 27 to 75 per cent, and medical staff also spoke very positively about it, concludes Dr Schell.
“One nurse said that ‘I love working now! Before, a seriously ill patients was the worst thing that could happen, but now we know what we have to do.’ ”
A mark of quality
Their research garnered considerable global attention and was awarded the Lancet-Elsevier Foundation Evidence to Impact Award. Dr Schell calls it a “mark of quality”.
“Hopefully it’ll mean that we can now accelerate our work,” he says.
Dr Baker says that although they already lecture on EECC around the world, the award will give their words renewed gravitas.
“We researchers are not the only ones who say that it works, an extremely respected institution like the Lancet also asserts that this implementation that KI is involved in is one of the best in the world,” he says. “Research is often far from future clinical application, assuming it reaches that far, but here we’re uniting the two worlds of research and implementation.”
They appreciate that the prize will open doors, but stress other important recognition of their work.
“What makes us happy is the nurse who now finds satisfaction in their work, or the baby who survived because someone gave them vital oxygen,” says Dr Baker.
Preparedness is about making the right priorities
They have since founded EECC Global, an organisation with members in 127 countries that trains motivated healthcare workers, who create national “hubs” for implementing EECC. Currently, the strongest hubs are in Tanzania and Sverige, but there are other leading hubs in Malawi, Ethiopia and Ghana.
“Our vision is that everyone in the world needing access to EECC gets it, that it’s a human right; no one need die in hospital because they don’t receive these basic treatments,” says Dr Baker, who adds that even though he and Dr Schell have often worked on different continents, they are in almost daily telephone contact.
“We both want to make the world a better place,” he says. “Giving more people access to EECC is a step in the right direction.”
Dr Schell presses the point that it is important in terms of preparedness to prioritise the care that makes the greatest difference to the population.
“When the resources dry up, be it under normal circumstances or during a health crisis brought on by war or a pandemic, we need to focus on the most important interventions,” he says.
Text: Lotta Fredholm
Translation: Neil Betteridge
Prize for putting research to practical use
The prize is awarded by the Elsevier Foundation and the science periodical The Lancet. The Evidence to Impact Award aims to highlight the importance of implementation science, an approach focused on translating research into practical, context-specific strategies that have the potential to drive systemic change across diverse settings.
The scientific jury selected the winning teams based on four criteria: demonstrated community need, meaningful co-design, clear implementation strategies and outcomes, and long-term sustainability. Each team receives a 10,000-dollar recognition award to support their work.
The Essential Emergency and Critical Care in Tanzania has been a collaboration between the Tanzania’s Ministry of Health, Muhimbili University of Health and Allied Sciences and UNICEF, with scientific support from Karolinska Institutet.
Essential care for the critically ill
EECC stands for Essential Emergency and Critical Care. The concept comprises 40 simple interventions that can reduce mortality in critically ill patients. It entails being able to identify critical illness and provide the right treatments.
The treatments can be provided at regular hospital units and clinics and include monitoring vital parameters, placing an unconscious parent in a stable recovery position or supplying oxygen.
So far this year (2026), 39 national professional associations around the world, including the American Society of Anaesthesiologists, have signed a declaration to ensure the universal implementation of EECC, so that no patient is denied their right to life-saving treatment.