Study Evaluating Multifaceted Support for the Implementation of Recommendations for the Prevention and Management of Anemia in Intensive Care Units

• implementation of recommendations (Other): The study will be organized into three periods: * a pre-implementation phase, with no changes to usual care; * a period of implementation of the recommendations; * a post-implementation phase.

Primary outcomes

• evaluate the impact of multifaceted support for STOP-A implementation on hospital mortality, taking into account the stepped wedge design structure. [Day 0 to Day 90]: in-hospital mortality, up to day 90

Secondary outcomes

• Evaluate the impact of implementation support on Hb levels [hospital discharge or day 28]: hemoglobin level in g/dl
• Assess the impact of implementation support on recovery after ICU discharge. [Day 90]: number of days living in the previous place of residence prior to D90
• Evaluate impact of implementation support on longer-term mortality [6 Months]: all-cause mortality at 6 months
• Assess the impact of implementation support on survival [6 months]: 6-month survival curves
• Assess the impact of implementation support (STOP-A) on professional practices [From enrollment to the end of recruitment]: RFE compliance rate (calculation of an RFE compliance index, IRR, comprising 6 items and scored out of 8 points) between the pre-implementation and post-implementation phases
• Assess the impact of implementation support on transfusion use between the two phases. [From enrollment to the end of recruitment]: Rate of transfused patients relative to the number of hospitalized patients in each phase
• Assess impact of implementation support on transfusion use between the two phases. [From enrollment to the end of recruitment]: transfusion index relative to the number of hospitalized patients in each phase
• Assess the impact of implementation support on transfusion use between the two phases. [From enrollment to the end of recruitment]: the number of red blood cell units relative to the number of hospitalized patients
• Analysis of the impact of compliance with recommendations on patient outcomes regardless of the study phase [day 90]: The primary endpoint (in-hospital mortality) and secondary endpoints will be analyzed in subgroups of patients with an IRR >75% vs. <20%;
• Analysis of the impact of compliance with recommendations on patient outcomes regardless of the study phase [day 90]: The primary endpoint (in-hospital mortality) and secondary endpoints will be analyzed according to IRR quartiles.
• Evaluate the impact of implementation support (STOP-A) in traumatized and non-traumatized patients. [Day 90]
• Evaluate the impact of EPO treatment in patients with Hb<12 g/dL [Day 90]
• Evaluate the impact of implementation support (STOP-A) on complications due to healthcare [hospital discharge or day 28]: thromboembolic events occurring in intensive care
• Evaluate the impact of implementation support (STOP-A) on complications due to healthcare [hospital discharge or day 28]: transfusion-related adverse events
• Evaluate the efficiency of assistance in implementing RFEs (STOP-A) through a cost-effectiveness analysis. [day 180]: Differential cost-effectiveness ratio, expressed as cost per life year gained at 3 and 6 months after admission to intensive care, from the perspective of the French healthcare system and from the hospital perspective.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Length of stay in intensive care is ≥ 2 days
* The patient has at least one organ failure lasting 24 hours or more (catecholamine infusion and/or mechanical ventilation (invasive or NIV > 6 hours/day))
* No objection to data collection (patient or relative)

Exclusion Criteria:

* Terminally ill patient with limited active treatment options within 72 hours of admission.