The COVID-19 pandemic exposed major gaps in the U.S. healthcare system, prompting the National Emerging Special Pathogens Training and Education Center (NETEC) to form the National Special Pathogen System of Care (NSPS) to prepare the country for the next large-scale outbreak. Discovery, the Critical Care Research Network, and its Severe Acute Respiratory Infection – Preparedness (SARI-PREP) program are helping lead the way in this new vision. SARI-PREP is a key player in the effort to establish a coordinated and standardized healthcare network that provides high-quality care to parents with a special pathogen, while also protecting healthcare workers.
Discovery, launched in 2017, is the Society of Critical Care Medicine’s (SCCM) research network dedicated to funding critical care research. SARI-PREP is a prospective multicenter observational study that assesses patients hospitalized with SARI, whether due to COVID-19, influenza A or B, or other viral infections. The multicenter study is funded by the CDC Foundation and coordinated by Discovery.
This new partnership with NETEC is an important milestone for SARI-PREP, which was launched just two years ago.
“This important partnership demonstrates that critical care is an essential part of the care delivery system,” said Laura E. Evans, MD, MSc, FCCM, principal investigator of SARI-PREP and director of critical care/associate medical director of the University of Washington Medical Center Seattle. “To be at the table and prominently involved in development of the strategy and plan is important for us and our patients. We are playing a major role in designing a system that will work for us and for healthcare workers and patients.”
NSPS is a collaboration of NETEC, Discovery, SARI-PREP, and a number of other stakeholders. SARI-PREP investigators, including Dr. Evans, have been leaders in NETEC since it was created in 2015 after the Ebola epidemic to provide training and education during emerging outbreaks. But the program’s lack of an infrastructure component became glaringly apparent during the COVID-19 pandemic, leading to the formation of NSPS.
NETEC provided vital guidance and assistance during the pandemic through programs such as Project ECHO—a virtual peer-to peer clinical education system—and through virtual webinars and consultations. NSPS takes this assistance further, focusing on how systems work together. NSPS draws from examples such as the system that assigns each trauma center a level from 1 to 5 based on its resources. NSPS aims to develop a similar system, assessing how specialty care can be regionalized and how centers can support each other. The vision is to save lives through a sustained, standardized system of care that enables healthcare personnel and administrators to provide agile, high-quality care across the care delivery continuum during the next outbreak of a special pathogen.
The NSPS will frame its work on guiding principles that are:
- Patient- and community centered
- Accountable, coordinated, and collaborative
- High-quality and equitable
- Responsive
- Scalable and sustainable
The plan involves establishing and operationalizing the coordinating body and care delivery network through an operating model, financial foundation, and communications foundation. To unify and strengthen care across the care delivery and incident lifecycle, NSPS focuses on:
- Care delivery
- Community and coordination
- Workforce
- Research and knowledge generation
To sustain the infrastructure for this system, NSPS will rely on data and technology, monitoring and evaluation, financial stability, and the supply chain. The ultimate goal is zero preventable deaths after special pathogen infection, nimble network mobilization, and access to high-quality special pathogen care for the entire U.S. population. Knowing that the next special pathogen outbreak could strike at any moment, work on the implementation of NSPS is already underway.
A vital aspect of NSPS that is especially relevant to critical care is the idea of implementing a learning system that incorporates research, both clinical and operational, according to Dr. Evans. That research will focus not only on what happens to patients, but also on delivering care more effectively and efficiently. SARI-PREP brings that expertise to NSPS, sharing its work related to measuring the stress and strain on hospital systems and determining how that affects care delivery. “The key to this process is being really collaborative and being inclusive of all stakeholders,” said Dr. Evans. “That includes not just people in the healthcare delivery system but also payer groups, professional societies, healthcare administration, emergency management, and others. We want to learn all we can from other network systems such as the trauma system.”
