Hello everyone!
There are a few important items to discuss as we head to the end of summer.
First, congratulations to Steve Pastores who has been appointed to SCCM Council. With this appointment, Steve can no longer serve as a co-chair of the CCO KEG. If you are interested in becoming a co-Chair or would like to nominate someone, you can do so here on the forum or email me: john.oropello@mountsinai.org Once we have the candidates, we will set up a vote.
Second, where do we go from here as the CCO KEG?
Our goal is to provide information to advance the CCO model because we see how it improves patient care, opportunities for multidisciplinary critical care training and research. It's obvious that it is very difficult for anyone to form and advance the CCO model due to organizational obstacles including turf battles. Thus far we have 7 papers and have held 3 workshops at annual SCCM Congress to provide others with information and advice on how to create and advance the CCO model. But the growth of CCO's in number appears to be very gradual, and the state of governance of existing CCOs undergoes continual evolution – some stable and some growing or receding.
More is needed to advance the CCO model.
Help from larger organizations (e.g., The Joint Commission, AHA ) whose goal is to ensure that healthcare organizations deliver accessible, safe and high-quality care to patients may be needed. However, to convince these organizations that the CCO model is superior we will need objective data. The ALCCM Taskforce and the 7 papers we have published so far take us part of the way. More research will help to make our case for CCO adoption as a hospital organizational standard.
In terms of research about CCOs, it has been about 10 years since the first CCO survey was published. Although they share the basic the requirement to be headed by a physician and have primary governance over the majority, if not all, of the ICUs in the medical center, CCOs are very diverse in governance structure. What do you think about launching a follow up survey? Similar to the original study, this would involve utilizing multiple sources of information to find new CCOs as well as surveying existing CCOs for changes. These would be academic centers in keeping with the first survey.
Another potential study is to compare hospitals without CCOs to those with CCOs in terms of academic, financial and operational performance advantages that are achieved by bringing multiple distinct ICUs under an organized umbrella. It's a challenge to figure out how to approach such a study in terms of what centers to compare, the data to obtain, and how to acquire the data. Any thoughts on how we might begin to tackle this?
Another potential avenue to pursue is writing articles that describe the formation and evolution of our unique individual CCOs to provide objective data relating the governance structure of the CCO to the impact on quality care, patient safety, research, education, and professional development.
Do you have any other suggestions for CCO research?
What are your thoughts about the future direction of the CCO KEG?
Thank you for your dedication to the advancement of the organization of critical care!
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John Oropello MD, MCCM
Program Director, Critical Care Medicine Fellowship
Director, Transplant ICU
Mount Sinai School of Medicine
New York NY
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