IAM SCCM Winner:
One Venezuelan Physician Exemplifies the Strength of Perseverance and Dedication
Visit www.iamsccm.org for more information about the I AM SCCM Campaign and to read other inspirational stories.
In 2006, Pablo Perez-D'Empaire, MD, decided to attend his first Critical Care Congress. He traveled from his hospital in Caracas, Venezuela, to the 36th Critical Care Congress in Orlando, Florida, prompted by his mentors in Latin America who often stressed the extensive networking and learning opportunities of the meeting. The event – his first international conference – exceeded his expectations. Beyond the educational sessions and hands-on workshops, Congress opened personal and professional doors that enabled him to become a leader and champion in his country. His efforts serve as an inspiration and an example, prompting the Society of Critical Care Medicine (SCCM) to choose Perez-D'Empaire as the winner of the I AM SCCM campaign.
Throughout 2008, the Society has been recognizing its members and their dedication to improving patient centered care through the I AM SCCM campaign. Perez-D'Empaire is one of many whose achievements and experiences will be highlighted during the 38th Critical Care Congress in the hopes that their dedication may inspire others.
Perez-D'Empaire’s I AM SCCM story began when he met R. Phillip Dellinger, MD, FCCM, during a pre-Congress educational session in Orlando. Dellinger told him about the Surviving Sepsis Campaign (SSC) and its mission to improve the management, diagnosis and treatment of sepsis. “I was really interested in bringing the Campaign back to Venezuela because there were no similar efforts to improve sepsis care in my country,” Perez-D'Empaire remembered. “The Campaign seemed like a good opportunity to bring attention to quality improvement in the Venezuelan critical care community. Because of our limitations as a developing country, we sometimes forget that new alternatives are available to provide the right care to our patients.”
Though Perez-D'Empaire’s institution, Hospital de Clinicas Caracas, had been informally following the SSC guidelines, staff had not been measuring their results. They had no way to know if they were making progress and Perez-D'Empaire was aware of miscommunication problems between the intensive care unit (ICU) and the emergency room.
Empowered by new professional contacts, a refreshed commitment and the latest knowledge, Perez-D'Empaire returned to his critical care unit at Hospital de Clinicas Caracas with new ideas and tools to improve early identification and treatment of sepsis. He accessed materials via the SSC Web site and translated the information from English to Spanish, including the guidelines-related pocket guides, posters and slides. He then scheduled sepsis educational programs for multiprofessional teams from the ICU, emergency department and other hospital wards.
Soon, the SSC bundles began to be accepted as evidenced-based practice throughout the hospital, and performance was documented through use of the free SSC database. These efforts alone marked an important improvement in patient care. Once staff could see their progress and problem areas through documented results, they were more likely to embrace the protocols and work to identify and solve issues.
However, Perez-D'Empaire wanted to go further. While resuscitation and management bundle compliance results were improving, long-lasting, cultural change was needed. Teamwork and improved communication were key to ensuring sustainable results. He wanted to extend his effort and sought more resources from the Society.
Seeing Perez-D'Empaire's commitment to the Campaign, Dellinger invited him to participate in the SSC North American Summits. Hospital de Clinicas Caracas was the only institution represented in the Summit from outside the United States. The summits were organized as a series of workshops and networking opportunities among hospitals that had implemented the Campaign’s software-based performance improvement program and had begun collecting data.
The lessons learned at the SSC North American Summit paid off, and Perez- D'Empaire again returned to the hospital with fresh ideas. This time he taught the staff concepts related to the Institute of Healthcare Improvement’s Plan-Do-Study-Act cycle and implemented various communication strategies. “Teamwork is definitely a key to implementing a quality improvement program. Without attention to teamwork, none of this would have been possible,” Perez-D'Empaire said.
When it came time to share data with other North American SSC Summit participants, Hospital de Clinicas Caracas ranked among the top SSC performers in bundle compliance. The group has entered 102 charts into the database. Performance to date has indicated a resuscitation bundle compliance of 40.54% and a management bundle compliance of 67.56%. This stellar performance is a testimony to the entire team’s attention to evidence-based medicine.
“We were very proud of these results,” Perez-D'Empaire said. “I am very impressed with what Pablo was able to accomplish,” Dellinger said. “He took initiative after achieving success and engaged the Venezuelan Critical Care Society, which recognized his potential to lead Surviving Sepsis Campaign efforts within the country. His accomplishments are indeed impressive.”
Hospital de Clinicas Caracas was the first hospital in Venezuela to implement the SSC, but Perez-D'Empaire is determined to spread his knowledge throughout the region. He has worked with four hospitals within Caracas and with six hospitals from other Venezuelan cities to hold educational sessions, showcasing his hospital’s own successes and helping others achieve similar results. He communicates regularly with his Latin American colleagues in Brazil, Mexico, Chile and Argentina, who also are implementing the Campaign. This is the kind of knowledge-sharing that has made the SSC so successful; everyone can be a leader simply by sharing information and introducing the bundles to their colleagues at other hospitals, regardless of the size or location of the facility. “Showing our results to other hospitals has made others more enthusiastic about SSC implementation,” Perez- D'Empaire said. “Clinicians realize that with effective teamwork, it is possible to achieve better results despite the challenges in our healthcare system.”
“You will have a lot of obstacles, but if you really believe in the programs, you should try,” he said. “In Latin American, these types of programs are really needed because we have limited resources as developing countries. Programs like the Surviving Sepsis Campaign and organizations like the SCCM provide very important opportunities for doing new things.”
Perez-D'Empaire truly illustrates the spirit of I AM SCCM. Using the resources provided by SCCM and fueled by his drive to improve patient care, Perez-D'Empaire has made a difference that will reach far beyond his own practice. His efforts to implement the SSC will have lasting effects on patient care in Latin America. It is hoped that his story will inspire this year’s Congress attendees to return to their ICUs to generate their own stories of inspiration. “There is still a lot of work ahead and many goals to achieve, but becoming an SCCM member was definitely an important step on my professional development,” Perez-D'Empaire said. “That is why I am very proud to say that I am SCCM.”
