The Society of Critical Care Medicine continues to pursue key initiatives that address the critical care workforce shortage.

The Society of Critical Care Medicine (SCCM) has long expressed concern with the current and future workforce needed for quality critical care. Throughout the past year, SCCM took four major steps to persuade others that this is a crucial issue affecting current and future critically ill or injured patients.

The Society joined a national nursing effort (the Americans for Nursing Shortage Relief [ANSR] Alliance) to address nursing shortages; successfully lobbied the American Medical Association (AMA) to expressly acknowledge the widening workforce shortage; formally registered support with the U.S. House of Representatives regarding recently introduced legislation pertinent to workforce shortages; and pressured Congress during National Critical Care Awareness Month (NCCAM) with a grassroots campaign involving SCCM’s new online advocacy tool, CapWiz®. Each of these efforts complements SCCM’s continued collaboration with other organizations concerned about the future of critical care.

Joining the ANSR Alliance
The Society supported the Americans for Nursing Shortage Relief Alliance (ANSR Alliance) in November 2003, underscoring the Society’s effort to address workforce issues for all members of the intensive care unit (ICU) team. The move followed collaborations on part of the Joint Leadership group, a coalition of four critical care societies: The Society of Critical Care Medicine, American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and American Association of Critical-Care Nurses (AACN). This alliance produced the consensus document, Assuring Quality Health Care for the United States: Supporting Nurse Education and Training, which outlines consensus issues that must be addressed to alleviate the nation’s nursing shortage. These issues include increasing the capacity to provide the supply of nurses, promoting quality patient care, and developing community based solutions and research into future solutions.

Acknowledging the Physician Shortage
The AMA focuses its efforts on advocacy issues during its interim meeting each December. Russell C. Raphaely, MD, FCCM and William T. Peruzzi, MD, FCCM represented SCCM at the 2003 meeting.

The key initiative for that meeting was Resolution 807 on the U.S. physician shortage, which SCCM co-sponsored with ATS and ACCP. The concern was two-fold: to focus the attention of the U.S. House of Representatives on the physician shortage issue, noting it affects all specialties and areas; and to demonstrate this shortage is supported by evidence and not merely anecdote. While the Society naturally presented data specific to critical care, additional data indicated a similar trend in other specialties, which was important to rallying support from the entire AMA.

The Society’s efforts were successful, helping to rescind the previous AMA policy regarding a physician surplus, and also to adopt the resolution explicitly acknowledging a shortage in specific specialties. The final outcome went further than we had first hoped: AMA will now monitor the trends in all specialties and geographies, and will advocate at federal and state levels to remedy the shortage wherever it manifests. Progress reports on such monitoring were presented at the June 2004 meeting of the AMA’s House of Delegates.

Supporting Education Tax Legislation
In November 2003, the Society joined the American Dental Education Association (ADEA) and more than 40 other healthcare and education groups in writing a letter to Rep. Philip English, R-Penn., to support legislation he introduced, the Higher Education Affordability and Equity Act of 2003 (H.R. 3412). This bill would improve current education tax law by amending the Internal Revenue Code of 1986 to expand incentives for education.

Representative English is obtaining co-signers for his bill, which currently has more than 24 co-sponsors.

Promoting National Critical Care Awareness Month
In May, the Society inaugurated its new online advocacy tool, CapWiz®, through a joint campaign including SCCM and other critical care organizations. CapWiz® serves as SCCM’s new Legislative Action Center and streamlines the member process of contacting key decision makers in Congress. By allowing members to easily search for their representatives and access letters that have already been drafted, the entire process of making critical care voices heard is simplified. Individuals can focus on making contact
and adding personal thoughts to communications.

The Society used CapWiz’s® features to full advantage in May during National Critical Care Awareness Month. The initiative targeted the U.S. Congress with a letter-writing campaign designed to highlight the workforce crisis facing the critical care community. The Society, along with AACN, ACCP and ATS, designed background materials, a marketing campaign to encourage member participation, and prepared a letter to elected officials.

Nearly 100,000 members of the four organizations were contacted and offered the opportunity to communicate their concerns directly to their federal leaders. The system outlined vital information on the workforce shortage, directed users into a collective appeal to Congress, and prompted action by listing specific options for letters to each legislator. The results were tracked for follow-up and future actions. CapWiz® also supports an Action eList, a roster of individuals concerned about policy issues affecting critical care and willing to join in advocacy efforts. From May 17 to May 19, this coordinated action led to hundreds of letters delivered to the representatives and senators serving SCCM members and the members of the other organizations. The campaign crowned a month of activities, including material distributed at SCCM’s booth at AACN’s annual meeting in Orlando; an international day of recognition (May 14) for the critical care team, in which supporters wore blue to draw attention to National Critical Care Awareness Month; and highlights of the many resources available from SCCM that promote quality care for critically ill or injured patients.

The Society’s first online campaign was quite successful and will serve as a basis for further action throughout the year to build on the grassroots momentum of addressing the workforce shortage and other issues.

What now?
The Society continues to work for remedies and relief from the current workforce shortage. There is room for member participation in these efforts, in the community, ICU, and with patients. Spread the word among colleagues and administrators and keep abreast of these and other SCCM efforts.