Advocate for Improved Patient Care

2010 - 4 August - Pregnancy in the ICU
Eight Tips from the SCCM Advocacy Committee for Getting More Involved in the Issues Affecting Critical Care

Most critical care professionals see themselves as patient advocates within their practice, working to ensure that the best, most appropriate care is delivered in a timely fashion. But, your expertise as a critical care professional is key to developing better clinical practice, patient rights, research policies and regulations on a broader scale. You can take an active role in improving overall critical care at a level of involvement that works for you.
Representatives of the Society of Critical Care Medicine (SCCM), the American Thoracic Society, the American Association of Critical-Care Nurses and the American College of Chest Physicians constitute the Critical Care Societies Collaborative. Advancing a united front to speak out and speak to issues impacting critical care, this group has achieved several successes. Most notably, the Collaborative helped convince the Centers for Medicare & Medicaid Services (CMS) to reduce the number of conditions it ultimately identified as “never” events. Additionally, the Society has a number of liaisons participating in committees at the American Medical Association, the National Quality Forum, the Centers for Disease Control and Prevention and the Hospital Quality Alliance. These volunteers and their staff partners work diligently to advance critical care awareness and keep leadership informed of key issues emerging on the national health agendas of government and policy-setting groups.
The work performed by the Critical Care Societies Collaborative is important, but grassroots efforts are key in shaping legislation and policies long before they are enacted and enforced. Policy decisions currently under review that can directly affect your practice include pay for performance, quality measures, public reporting and the medical home. Members of SCCM’s leadership and Creative Community are hard at work addressing these issues on various fronts, but there is a role for all interested members to play.
Apply these tips to begin advocating for your patients.
Educate Yourself - Critical care is a demanding profession, and it is hard enough to stay up to date on the latest clinical information. But, understanding external influences that may impact patient care and payment is an important aspect of the profession. Such issues can affect your practice in a major way; they may influence your patient load, your reimbursement, the rules of your practice, and your data collection and reporting habits, leading to ever-increasing public scrutiny. All these issue touch on the quality of care for patients. By educating yourself on the issues, you ensure that the critical care community is leading the discussion rather than simply reacting to changes.
Approach with Passion - There are endless issues that may interest you at any given time, so it is important to take a step back and reflect on these options. To be effective on a personal level, you must choose one or two issues about which you are passionate. Each of us has limited time and energy; use them wisely. Advocating for improved critical care will come easier if you are emotionally tied to the issue or highly vested in the outcome.
Become Involved in Your Professional Society - From the standpoint of an elected official, the only thing better than a registered voter is one who also is well versed in the issues. Policy makers appreciate input from professionals in the field. Engaging in activities within SCCM speaks to your credibility. In addition, you gain access to the relevant and timely issues, resources and networking opportunities.
Set Goals - Advocating for your patients is a project, and all the basic management skills apply. Set goals using metrics and timelines to provide perspective and reduce frustration. Just as in your clinical practice, setting goals also allows you to measure your success. Celebrate small successes and build on them – and if goals aren’t met, assess why. You may need to redirect your course or refocus.
Start Locally - Involvement at the local level is a good start; it allows you to take realistic first steps, establish a network and gain contacts. Local opportunities abound. Contact your state medical board, your representative’s local office, or a local chapter of like-minded professionals.
Communicate Effectively - Remember, your opinion as a medical professional and critical care expert matters. Whether you e-mail, write, call or make a personal visit during your efforts, you will be heard if you communicate effectively. Visit to find resources that can be used to identify decision makers, research new legislation or regulations and keep abreast of developments. Bring both facts and stories that have an emotional punch.
Build Relationships - Educating those that make policy and develop regulations is very useful. If you do not have a personal referral to contact such people, consider contacting liaisons for healthcare policy; they are fairly accessible and they understand how to effectively frame issues to get results. CMS’s chief medical officers are also a great, untapped resource. These physicians, located in each CMS region, are open to your ideas and interested in hearing from colleagues.
Engage Your Colleagues - There is strength in numbers and you may wish to delegate some tasks. Your colleagues often have additional facts, contacts and access to other resources. The key here is networking, networking and more networking.
Judith Stechert, RN, and other members of the SCCM Advocacy Committee contributed to this article. For more information visit