Successful Launch of the Netherlands Surviving Sepsis Campaign

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Successful Launch of the Netherlands Surviving
Sepsis Campaign

• A.R.H. van Zanten, MD D.H.T. Tjan, MD
• On behalf of the Steering Group SSC The
  Netherlands
• Department of Intensive Care
• Gelderse Vallei Hospital, Ede, The Netherlands

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Netherlands
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(No Transcript)
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Number of intensivistsin 97 ICUs of 102 hospitals
Closed format possible
Fte full time equivalent
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Days on MV and off MV in level I, II and III ICUs

• 95 hospitals (of 102) in total 174.496 MV days
  (range 0 gt10.000) per annum.
• Mean MV days level III 4745
• level II 1225
• level I 620

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Incidence of sepsis in the Netherlands

• Severe Sepsis
• 0.9 of all hospital admissions
• 17 of all ICU admissions

Van Gestel A et al. Crit Care. 2004
Aug8(4)R153-62
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Costs of sepsis treatment

• USA 16,7 bln
• ------------------------------------------------
• UK 0,420 0,488 bln
• France 1,421 2,270
• Germany 1,988 2,408
• Italy 0,312 0,382
• Spain 0,493
• Netherlands 0,190 0,329
• Overall Europe 4,825 6,370

300 mln !!
Angus et al. Crit Care Med 200129(7)1303-1310
Davies et al. Intensive Care Med 200127S2
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Severe sepsis incidence NL 2003-2004Source
National Intensive Care Evaluation (NICE)
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Dutch intensivists do not use small tidal volumes
during MV
E Wolthuis, P Spronk, M Kuiper, M Vroom and M
SchultzCritical Care 2004, 8(Suppl 1)P26     
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Xigris ( aPC) in Europe in 2004
Mortality in Prowess/Enhance trial Drotrecogin
alpha vs. placebo in The Netherlands
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A good start.

• We felt that a launch symposium could be a good
  strategy to start off the campaign.
• Many initiatives, a lot of work for Dutch ICUs
• Quality indicators
• New guidelines on organisational aspects of
  Intensive Care
• DRG reimbursement
• We evaluated whether this introduction strategy
  was successful in order to increase the number of
  participating hospitals.

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Launch 9 december 2005
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Symposium preparations

• On December 9 2005 an international committee of
  intensivists organised a national launch
  symposium for ICU physicians, ICU nurses and
  other healthcare workers interested in sepsis.
• Organising Committee
• M. Levy, director of Critical Care, Medical
  Intensive Care, Rhode Island Hospital,
  Providence, USA
• G. Ramsay, surgeon-intensivist, Medical Director,
  Atrium Medical Center, Heerlen
• D.H.T. Tjan, anesthesiologist-intensivist,
  Gelderse Vallei Hospital, Ede
• A.R.H. van Zanten, internist-intensivist,
  Gelderse Vallei Hospital, Ede
• We send out invitations (posters and brochures)
  to all ICUs in The Netherlands and medical
  specialists involved in intensive care medicine.

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Programme

• Well-known speakers addressed topics such as
• Sepsis definitions
• Antimicrobial therapy
• Tight glucose regulation,
• Early-goal-directed-therapy
• Microcirculation
• Steroids
• DIC and aPC
• Lung protective ventilation
• Sepsis guidelines and SSC
• The official launch was announced.
• A social night programme was optional.
• The next day the first user group meeting was
  held.

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Speakers and chairpersons

• Jan Bakker, Erasmus MC Rotterdam
• Marc Bonten, UMCU, Utrecht
• Can Ince, Academisch Medical Center, Amsterdam
• Henk van Leeuwen, Gelderse Vallei Hospital, Ede
• Marcel Levi, Academisch Medisch Centrum,
  Amsterdam
• Mitchell Levy, Rhode Island Hospital, Providence,
  USA
• Graham Ramsay, Atrium Medical Center, Heerlen
• Hendrik-Jan Stienstra, Gelderse Vallei Hospital,
  Ede
• David Tjan, Gelderse Vallei Hospital, Ede
• Miriam van Veen, Gelderse Vallei Hospital, Ede
• Arthur van Zanten, Gelderse Vallei Hospital, Ede
• Jan Harm Zwaveling, University Medical Center
  Maastricht

Both doctors and nurses
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Results of the symposium strategy

• We send out 5200 individual invitations to MDs
  and RNs and 1500 posters to all Dutch hospitals.
• Symposium
• 43 hospitals attended the symposium (of 102)
• Number of participants182 (3,5 of invited
  persons)
• The MDRN-ratio was 113/69.
• Sponsors 14.
• Speakers12.
• User group meeting
• 48 participants of 24 Dutch hospitals (24 of all
  hospitals). Speakers 2.

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Emmen
Hoorn
Zwolle
Haarlem
Harderwijk
Amsterdam
Ede
Hilversum
Tiel
Nieuwegein
Nijmegen
Dordrecht
Veghel
Breda
Vlissingen
Roosendaal
Sittard
Heerlen
Participation first training session Saturday 10
December 2005
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Enrolment of hospitals in Netherlands Surviving
Sepsis Campaign
Gelderse Vallei hospital will host database
management for Dutch participating centers

• National Steering Group SSCN
• David Tjan, Chair
• Arthur van Zanten, international liaison officer
• Harold Faber, Treasurer
• Hasra Biemond, Secretary
• Mehta van der Woude
• Andre Stamkot

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SSC Netherlands hospitals January 2006

• Wilhelmina Hospital, Assen
• Atrium Medical Center, Heerlen
• Franciscus Hospital, Roosendaal
• Antonius Hospital, Nieuwegein
• Albert Schweitzer Hospital, Dordrecht
• Westfries Gasthuis, Hoorn
• Kennemer Gasthuis, Haarlem
• Bernhoven Hospital, Veghel
• Antoni van Leeuwenhoek Hospital, Amsterdam
• Gelderse Vallei Hospital, Ede

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Conclusions

• Since 2 months Dutch hospitals participate in the
  international Surviving Sepsis Campaign
• A launch symposium will probably enhance
  enrolment of ICUs
• About 10 of hospitals and ICU beds in The
  Netherlands are represented by the SSCN
• About 5 of hospitals are considering
  participation
• We plan to organise
• Bimonthly steering group meetings
• Meetings with all centers (2x/year)
• Yearly symposium
• A national database that will produce data output
  to the international database
• A national SSCN website
• A SSCN newsletter
• Adverts in the Netherlands Journal of Critical
  Care

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STOP
SEPSIS
IN NL
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Join the campaign!