Adult Sepsis Guidelines
Children's Sepsis Guidelines
Adult ICU Liberation Guidelines
PANDEM Guidelines for Children and Infants
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SCCM is updating its SCCM Connect Community. Access to SCCM Connect may be limited until April 23.
David J. Martin, CAE
Every day across the globe there are critically ill and injured patients whose outcomes are better because of the collective engagement of SCCM’s worldwide membership. Yet most of our communications are about the needs of our diverse group of clinician members, such as attending courses or downloading clinical practice guidelines. We do not often take the time to highlight SCCM’s other work or the improvement in outcomes these activities bring. The Society has a broad range of initiatives in addition to its core programs, such as the annual Congress and scientific journals, that are also highly mission focused,
During 2017 SCCM completed phase 1 of the work on how sepsis care can be improved in resource-limited settings with a program in Gitwe, Rwanda. We began working to apply those learnings to tools that can be used in similar areas worldwide, moving local learnings out through our global network. The special Gitwe, Rwanda, project was developed in partnership with the Hellman Foundation and King Baudouin Foundation; a publication detailing these results will be released shortly.
The Society piloted its first community outreach efforts in 2017, aimed at educating the public on key health issues in critical care. These activities focus on how to improve chances of surviving when critical health events occur. In the first activity, 330 grade school students in the state of Georgia received CPR training with mannequins donated by SCCM and the Weil Family Foundation, with instructors provided by the Citizen CPR Foundation. Additionally, SCCM worked closely with the City of San Antonio to plan a major public health fair just prior to the 2018 Congress. It included a broad array of programs and partners from the local community with a like-minded interest in reaching out to a diverse public on health-related topics.
When disasters struck in 2017, they came in quantity. On August 27, SCCM activated its emergency response protocol as Hurricane Harvey devastated portions of Texas
and Louisiana. Since 2001, when the Society mobilized a response to the terrorist attacks in New York City, SCCM has activated the program more than 20 times and channeled member volunteers from across the globe to help those in greatest need during times of crisis. During 2017, 160 pediatric intensive care unit (ICU) nurses and 35 physicians answered our call for volunteers to go to the aid of colleagues during the Texas floods. Additionally, more than 300 volunteered to travel to Puerto Rico when Hurricanes Irma and Maria struck the Caribbean.
In 2005 we expanded our capacity beyond volunteer recruitment, to include working with our vendor community to donate medical supplies to ICUs impacted by disasters. And last year our vendor community responded by sending thousands of badly needed medical supplies to Puerto Rico and donating capital equipment such as mechanical ventilators.
In 2017 we expanded our program once again, when SCCM was asked if we could send nonmedical supplies such as diapers, baby food, clothing, and other items ins hort supply to Puerto Rico’s pediatric hospitals. As in every previous effort, the SCCM community responded in force, donating thousands of items through SCCM’s Amazon Wish List. The effort was successful beyond our hopes. Our headquarters staff worked nights and weekends to keep up with the volume of donations, and the Society’s Congress event management company (GES Exposition Services) donated trucks and shipping services to get the supplies on scene quickly. To ensure that this generous outpouring of gifts made it to where need was greatest, I traveled to San Juan and met with SCCM members to see what other needs they had. During this time cash donations were also received from SCCM’s broad constituency, which permitted the Society to purchase additional equipment for the pediatric hospitals in San Juan.
We continue to experience a shortage of trained intensivists. In 2017 our Fundamentals programs, such as the Fundamental Critical Care Support (FCCS) course, were held for the first time in Ethiopia, Guatemala, Pakistan, Thailand, and other countries where needs are acute. Additionally, SCCM sponsored a training program in Nigeria to bring together over 200 healthcare providers from 45 countries across Africa. There our goal was to train these providers so they could return home better prepared to care for their patients and to teach others what they had learned. It is this sharing of information that makes our community so effective and exemplifies the impact of our global reach on local care.
Additionally, SCCM members and staff worked diligently to expand the Fundamentals program to include new courses on tropical diseases and care of the obstetrics patient. Overall, more than 15,000 individuals were trained in just 12 short months.
Discovery, the Critical Care Research Network, was formed in 2017 when the United States Critical Illness and Injury Trials (USCIIT) and the Critical Care Pharmacotherapy Trials Network (CCPTN) joined with SCCM to launch a comprehensive critical care research network. Members of a diverse leadership group provide guidance to an inclusive, integrated, multiprofessional research network that improves outcomes across the continuum of care for critically ill patients and their families. Discovery provides several options for clinical investigators. During one of several yearly meetings, including one at the National Institutes of Health and one at the SCCM annual meeting, it considers new research proposals. The top proposals are selected for oral presentation. The remaining proposals receive feedback and the possibility for poster presentation. Discovery also provides networking abilities for clinical investigators to find potential collaborators and advisors. Finally, Discovery has yearly seed grant funding for trials that are deemed likely to create new knowledge that will help improve patient care and be competitive for national and foundation grants.
SCCM’s primary dissemination tools for research are its two journals, Critical Care Medicine (CCM) and Pediatric Critical Care Medicine (PCCM). In 2017 CCM published multiple new guidelines, including the highly anticipated Surviving Sepsis Campaign guidelines, and PCCM published its first SCCM pediatric guideline. CCM’s 2016 impact factor was 7.050, while PCCM’s was 3.495. Increased social media efforts more than doubled the number of PCCM Twitter followers in 2017.
In 2017 the online versions of CCM and PCCM moved to a responsive design platform, allowing users to easily view the journals on any mobile device. Both journals’ web pages were redesigned as well, and readers are now able to share articles via e-mail and social media outlets with the click of a button.
In partnership with the American Association of Critical-Care Nurses, American Thoracic Society, and American College of Chest Physicians (who, along with SCCM, make up the Critical Care Societies Collaborative), SCCM hosted a National Summit on Prevention and Management of Burnout in the ICU to explore burnout influences, ramifications, and potential traditional and nontraditional solutions. A writing group has been convened to publish findings that will include research gap identification to further explore opportunities for research related to burnout challenges facing ICU clinicians.
SCCM’s broad array of educational conferences, online learning programs, and publications address every facet of critical care. These are the programs most well known to our multiprofessional membership. The Society’s 46th Critical Care Congress in Honolulu shattered all previous records. Professional registration rose 12%, to an all-time high of over 5,200. Including exhibitors, total attendance topped 6,000. Abstract submissions increased by 45%, with just under 2,000 accepted for presentation. As such, the Congress was also financially successful.
In 2017 the first round of major changes were made to the Multiprofessional Critical Care Review Courses (MCCRCs), positively impacting attendance, which rose by 18% to over 300 learners at the in-person course. Online learning also continued to do well, with nearly $300,000 in sales across all online programs. SCCM’s Critical Care Ultrasound: Adult was held for the first time in Tehran, Iran, and Barcelona, Spain, while the pediatric version debuted in Tokyo, Japan. SCCM also released a new book,Mechanical Ventilation: Essentials for Current Adult and Pediatric Practice.
The Society successfully concluded two quality improvement collaboratives encompassing 145 ICUs. The collaboratives focused on SCCM’s ICU Liberation program (ABCDEF bundle) funded by the Gordon and Betty Moore Foundation and patient- and family-centered care strategies funded by the Patient-Centered Outcomes Research Institute (PCORI).* Both collaboratives reported marked improvements in multiprofessional collaboration and positive family interactions. Data are being analyzed, and publication of results is forthcoming. A third collaborative effort to reduce catheter-associated urinary tract infections and central line-associated bloodstream infections in ICUs included SCCM experts in cooperation with the American Hospital Association’s Health Research & Educational Trust, the Centers for Disease Control and Prevention, and the Agency for Healthcare Research and Quality. This activity has been renewed, with recruitment of more than 400 ICUs, because of its success in reducing these types of common infections in ICU patients.
The Surviving Sepsis Campaign (SSC) has reset the standard of care for septic patients and focused importance on early recognition and treatment. Revised SSC guidelines for adult patients were presented at the 2017 Congress in Hawaii, and an SSC guideline for the treatment of children is underway. SCCM continues to work closely with the World Health Organization as it strives to understand the global impact of sepsis, particularly with relation to maternal and fetal sepsis.
Patient- and Family-Focused Activities
The year 2017 saw the conclusion of phase 1 of the THRIVE initiative, aimed at gaining a better understanding of patients who have post-intensive care syndrome (PICS) and what tools are being used to help them recover after a long ICU stay. Sketch videos that have proven to be helpful to patients and families are available at www. MyICUCare.org. The Society also released a booklet for families who have a loved one in the ICU, Understanding Your ICU Stay, which covers 13 topics, from support options to commonly used equipment, as well as information on PICS. The booklet can be downloaded at no cost and read online or purchased for use in ICU waiting areas. Based on the early learnings and achievements of the THRIVE Task Force, SCCM’s Council approved phase 2 of the program, which provides five more years of funding to identify which tools are most effective in the identification and treatment of PICS.
To support the operational activities of SCCM’s broad array of programming, the Society invested in upgrades to our administrative offices, tele-/videoconference systems, and conference registration systems, and continued our efforts to move SCCM’s data storage into secure cloud environments, increasing accessibility by our growing professional staff. The Society’s customer relationship database system was also upgraded and connected to the U.S. National Provider Information database to improve data quality.
Membership and Finances
Throughout 2017 the SCCM Council continued to discuss the Society’s membership structure and received numerous reports from the Membership Committee and the consulting firm hired for this project. The Council ultimately concluded that a new structure should be implemented based on tiers that more closely align cost of membership with members’ needs and the benefits they receive. Staff will work to implement the new system during 2018-2019. Total membership in SCCM remains at approximately 16,000, although movement of members to higher dues -paying categories continues to occur, increasing revenue from membership dues to 27% of all operating income. The Society’s primary source of income came from its knowledge and skills business line (38%), which includes the annual Congress. The research/journals (14%), Fundamentals (9%) and review/assessment (9%) business lines rounded out the top five activities that generated the majority of all operating revenue.
Overall, the Society’s financial position was very strong, with total net assets increasing to $27.4 million from $25.7 million the previous year. Of these net assets, $4.9 million were fixed assets net of depreciation, with the remainder in cash and investments. The Society has no long-term debt. In total, the Society enjoyed a net income of $1.7 million on $20 million in gross revenues. Net revenue from program operations was $682,000 after receipt of reserve funds in the amount of $765,000 to primarily support the development of the THRIVE program (PICS) and the launch of the new Discovery research network. The balance of overall Society net earnings came primarily from investments.
SCCM offers much more than just professional education. It remains highly focused on its overall mission of improving care of the critically ill and injured so that patients enjoy optimal outcomes.
None of these activities would be possible without the more than 1,800 members who volunteer their time and talent to develop and deliver SCCM’s wide range of programs. Likewise, those who donate to SCCM make it possible to expand our programming and to respond when disaster strikes. Last year alone, charitable gifts to the Society topped $300,000. SCCM is also proud to be supported by the healthcare industry, who provide funding through advertising, exhibiting, grants, and gifts. And of course, many of our quality improvement and research initiatives would not happen without the funding provided by foundations and governments who share our passion to improve outcomes. So, whether you support SCCM in one of these ways, or you support it through your dues payments, attendance at conferences, or purchasing publications, know that each and every dollar is used wisely and with our mission in mind. However you support SCCM, we are proud to call you part of the SCCM family and want you to know that your support improves individual care on a global scale. Thank you!
*The Patient-Centered Outcomes Research Institute (PCORI) is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed healthcare decisions. PCORI is committed to continually seeking input from a broad range of stakeholders to guide its work.