Dr. Jeffrey Grossman: Sen. Baldwin's Bill Helps Improve Critical Care

A bipartisan bill has refocused Congress’ attention on the unique challenges faced by critical care providers and intensive care units across our country.

The bill by U.S. Sens. Tammy Baldwin, D-Madison, and Rob Portman, R-Ohio, is called the Critical Care Assessment and Improvement Act of 2014. It will address many of the concerns about the critical care delivery system shared by hospitals and providers throughout Wisconsin, including UW Health.

This bill’s importance is rooted in policies to modernize and strengthen the nation’s critical care infrastructure and maximize federal investments in critical care research. Critical care services need to be delivered in highly specialized facilities by highly trained nurses, physicians and other medical personnel.

A national critical care workforce shortage poses serious limitations on our ability to treat the sickest of patients, as the majority of intensive care units are already operating at capacity under normal circumstances, and would be stretched beyond their limits in the case of a public health emergency.

Sen. Baldwin’s bill acknowledges this problem by calling for a much-needed comprehensive assessment of the state of the critical care health infrastructure, including workforce capacity, and the development of recommendations to address limitations in the delivery system. This should bolster critical care capabilities to meet future demands.

As the nation’s third-largest recipient of funding from the National Institutes of Health, UW is particularly well positioned for research that can drive new therapeutic breakthroughs. Research funding in critical care has been somewhat problematic because, unlike diabetes or cancer, for example, critical illness is not a single disease, but a way that many diseases are expressed when they leave people very ill.

This has resulted in a scattering of critical care-related research projects throughout the 27 institutes of the NIH, rather than in a single, well-coordinated center, thus limiting the effectiveness of critical care research funding.

The Baldwin-Portman bill creates a Critical Care Working Group within NIH to coordinate the collection and analysis of critical care research, identify gaps in the research agenda, and strengthen partnerships between NIH and other public and private entities, such as UW. We think this will yield stronger critical care research and promote the development of better treatments for critically ill patients.

The nation continues to react to the health threat posed by Ebola, a deadly virus that reminds us of the role of critical care in our nation’s health system. Critical care delivery systems — including UW’s — will continue to be taxed even when the threat of a health crisis does not draw public attention.

That is why a comprehensive evaluation to improve our critical care delivery system is important, and why UW has been proud to support Sen. Baldwin’s leadership in championing policies to foster a stronger critical care infrastructure.

Grossman is president and CEO of the University of Wisconsin Medical Foundation. He is a critical care pulmonologist and senior associate dean for clinical affairs at the UW School of Medicine and Public Health. He is founding chairman of the Board of the Roundtable on Critical Care Policy.