2022 Critical Care Congress Plenary: Health System Readiness 2.0

Brendan G. Carr, MD, MA, MS, joined New York’s Mount Sinai Health System as chair of emergency medicine on February 1, 2020. On March 1, the state’s first COVID-19 patient was identified in the Mount Sinai Hospital emergency department. On April 1, a field hospital was opened in Central Park. “It was just surreal,” Dr. Carr said of the early months of the pandemic. “It’s safe to say the realities didn’t meet my expectations.”
 
Dr. Carr will address some of these realities during a plenary session at SCCM’s 2022 Congress. Dr. Carr will present the Peter Safar Memorial Lecture titled “Health System Readiness 2.0.” Dr. Carr views the early days of the pandemic from the perspective of both a clinician and an administrator. “On the clinical side, we couldn’t help our patients in the way that we were accustomed to,” he said. “Nothing worked. They just came in and crashed, and so much of what we expected to work just didn’t. The helplessness fed the fear. We’re accustomed to being able to predict, intervene, and control much of what is happening to our patients, and we just couldn’t.”
 
Dr. Carr played a key role in coordinating Mount Sinai’s response to COVID-19. Managing that fear and the growing anxiety of both staff and patients was particularly challenging. “We sent our workforce into a situation in which they felt unsafe,” he said. “We watched them isolate themselves from their families, we limited visitors, and we watched people die alone.”
 
Despite the obstacles brought on by COVID-19 during the past two years, Dr. Carr said he and his colleagues managed to accomplish many of the tasks he had intended when he was first hired, including integrating faculty across hospitals into one department of emergency medicine, creating innovative programs that intersect the Icahn School of Medicine at Mount Sinai with the health system’s priorities, and investing in building the future of healthcare delivery.
 
In his presentation, Dr. Carr will focus on health systems’ abilities to respond to any number of unexpected disruptions, including workforce challenges, cybersecurity threats, and supply chain shortages. “Natural events and man-made events are all within scope,” he said. “We’ve not seen one weakness in the system manifest, we’ve seen many. And our playbook to respond is incomplete.” To make that change, Dr. Carr said it is necessary to focus beyond patient care and realize that healthcare professionals are accountable to the larger communities who look to them for help during times of crisis. Dr. Carr channeled the wisdom of Peter Safar, who was one of SCCM’s founders. “If it’s worth doing,” Dr. Carr said, “it’s got to be done right now.”