1 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD The Graduate Training Program in Clinical Investigation, (GTPCI), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD The Graduate Training Program in Clinical Investigation, (GTPCI), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Department of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD.