Charles Durbin Jr., MD, FCCM
President
Society of Critical Care Medicine

Many Partners, One Goal

References 
  
While the workforce report and the Surviving Sepsis Campaign (SSC) are of special interest to the critical care practitioner, these issues also offer the opportunity to highlight the Society of Critical Care Medicine's (SCCM) budding partnerships with others in the healthcare community. These relationships have served to help the Society better patient care, and SCCM looks forward to more opportunities to enhance and nurture its professionalties and to improve care for the critically ill and injured.

The HRSA Workforce Report
At the urging of the Society, Congress directed the Heath Resources and Service Administration (HRSA) to study the current and future supply of intensivists and demand for critical care services. The agency issued a report confirming and extending the concern about the developing shortage of intensivists in the United States and stated that, even now, an inadequate number of intensive care unit (ICU) physicians exists to provide optimal care. This report was built on a study commissioned by SCCM, the American College of Chest Physicians (ACCP) and the American Thoracic Society (ATS). The Committee on Manpower for the Pulmonary and Critical Care Societies (COMPACCS) study, conducted in 2000, analyzed physician practices and population growth expectations, predicting a shortage of critical care physicians by 2007.1 The HRSA agrees with the conclusions from COMPACCS, stating that there are not enough specially trained physicians to provide optimal care today and that the shortage is expected to grow in coming years.

The results of the HRSA report come as no surprise to most of us. The surprise is in the strong statement made by the federal government. During a time when government reimbursement for specialist care is declining and budget constraints are looming, this report will gain much congressional attention, which will be incredibly helpful when requests for more intensivist training and support are made. The government has recognized shortages of other ICU team members, and additional funds to educate nurses and respiratory therapists have been appropriated (although not in sufficient amounts). If anyone with legislative contacts would like to use this information, please let the SCCM Advocacy Committee know of your plans by contacting committee chair Aryeh Shander, MD, FCCM, at aryeh.shander@ehmc.com or the committee's staff partner, Eric Chandler, at echandler@sccm.org. The committee can provide material for legislators and can help craft a message. The Society is working with Sen. Richard J. Durbin, D-IL, to draft legislation related to the report.

Confirmation of the shortage is a new position for the government.Throughout the past 25 years, the government has supported the belief that there are shortages of primary care physicians and that there were already too many specialists. This new information will change attitudes about specialty care. It is still important to emphasize that intensivists provide the most efficient ICU care. In fact, intensivists can be considered the “generalists” of the ICU. By demonstrating the improved outcomes achieved with a dedicated ICU team, healthcare personnel can make a stronger case when calling for staff and funding support.

The Surviving Sepsis Campaign
Another area discussed in this issue of Critical Connections is the effect of infection in critical care. With the initiative of “The Barcelona Declaration” during the European Society of Intensive Care Medicineʼs (ESICM) meeting in October 2002, SCCM, ESICM and the International Sepsis Forum launched the Surviving Sepsis Campaign with the aim to reduce the sepsis mortality rate by 25% worldwide five years after the publication of the guidelines.2 As a member of the SSC, the Society is developing a network of U.S. hospitals that are implementing the SSC care bundles and collecting data to assess the success of the campaign. The Society has organized regional training sessions to develop a cadre of individuals charged with helping others implement the SSC. Learn more about these sessions on page 7. The progress of the SSC on reducing the mortality rate will be available thanks to the participation of hospitals throughout the world who contributed data through SSC using a Web-based collection system.

The Society’s Collaborative Goals
The collaborative nature of the HRSA report response and the SSC show the direction the Society has been moving in for the past several years. To improve the care of all critically ill and injured patients requires cooperation with other societies and organizations on many levels. The Society cannot achieve its goals alone. These two collaborations indicate the success SCCM is having in the United States as well as internationally. Ongoing and growing relationships with other groups help expand our influence and success, all to the benefit of patients. In August, the SCCM Council will meet to discuss how far the SCCM should go in developing outside strategic relationships.

A prominent part of this planning meeting will include estimations related to the value and risks of these initiatives as well as reports on where we would like to see the organization in five and 10 years. Long-term thinking is important for the Society, but the time required to achieve this type of planning is limited by the leadership's busy professional lives. Future issues of Critical Connections will address the important ideas generated during this retreat.

While these are good omens, we cannot lose sight of the important daily goals of the organization to improve patient care. The Society continues to produce high-quality educational programs for our members and others, allowing participants to develop and practice new skills. Successes should be judged by changes measured at the bedside. The outcomes from the SSC training sessions should allow this level of measurement and analysis. For the first time, we may be able to document the effect a program has had on altering care and improving patient outcomes. This truly is an exciting time for all of us.