Time for a New Approach?

State of the Art 2015: Time for a New Approach?

Dr Ganesh Suntharalingam, ICS Council, and State of the Art 2015 Programme Organiser

As Tennyson (almost) said:  in the Spring, a young(ish) man’s fancy lightly turns to thoughts of … State of the Art 2015.  It’s the biggest event in the ICS calendar, and the largest meeting of critical care professionals in the UK.

It’s a pleasure and privilege to be this year’s programme organiser, on behalf of the Education, Training and Meetings Committee:  a role landed, I think, largely through the usual mechanism of being out of the room at a critical moment.  More seriously, it is an exciting responsibility – and we would like your active help in keeping it fresh, updating it where necessary, and producing the best meeting yet.

We would like, above all, to make sure that the State of the Art feels like your meeting – UK-based, run by your society, and open to your participation.  This isn’t just rhetoric: I’ll be ending this blog entry with my contact details, and I would be very happy to talk to you by email, Twitter, or (having established contact via one of these), phone if easier.   There is also an online survey that will be actively used to guide planning decisions (and which comes with the chance to win free entry to this year’s meeting or one year’s membership).

What to discuss?  Firstly, the content.  We had some excellent speakers in 2014, with some barnstorming performances by the likes of Peter Brindley; but your feedback so far tells us that you want more innovation in format and content to keep things fresh.  We hear you.

We also need to reflect developments in the world outside.  Last year, I was impressed by how busy the conference remained up until the very end of the third day, with a large audience drawn by presentations from the the big current UK studies.  State of the Art is the home of British critical care research, which is healthier than it has ever been, through the activities of trainees and tomorrow’s intensivists as well as the mjor ICF and ICNARC- studies.  Strategically, however, the timing of our meeting means that the by the end of the year the primary results of important studies are often already known: either through ESICM or (increasingly) through online medical networking, where emerging publications and interim presentations are Tweeted instantly among the global cognoscenti before the rest of us have got out of bed and opened the journal wrapper, or even our email inboxes.

This is an opportunity, rather than a threat: we should make State of the Art the place to come to interpret the latest science, network face-to-face with other UK clinicians, and hear more in-depth, reflective and practical analysis of what the emerging literature tells us about our frontline clinical practice.   We should aim to be as much Newsnight, as Six O’Clock News.   This doesn’t mean there is no place for the latest research results: but we should acknowledge that in many cases, people will already know them.  There is room for both primary reporting and more in-depth analysis, and we can make the most of these through new formats.

Suggestions already under consideration (all originating from conference attendees), point in the direction of more informality and interaction, including:

  • Pro-con debates
  • Masterclasses and interactive scenarios (“How I would manage…”)
  • Panel of experts sessions
  • Interactive ethics debates
  • Workforce and career development, including the critical care practitioner role
  • Medico-legal mock courtroom scenario
  • Social media and free open-access medical education in critical care – are they already influencing clinical practice?  If SoMe and #FOAMcc mean nothing to you (which is very likely), then all the more reason to come and find out…
  • An insight into a CQC inspection
  • Breakout ‘coffee house’ sessions to spend time directly with the speakers on a more informal basis

In my view, State of the Art already has some key selling points, and we have the potential to build on these – again based on what you would most like to see.

    • History: we have the existing track record and international presence (aided and abetted by Mervyn Singer’s bulging contacts book) to continue attracting the best international speakers as well as supporting the UK critical care research scene.;
    • Critical mass: It brings together British critical care professionals in large numbers, which means that UK-specific topics (training, research, medico-legal, regulatory, workforce) can be covered in a way that is directly relevant; and with the opportunity for more interaction and consultation with the professional audience.  An important reason to come to London is to share views and to learn things that will help you practice effectively and safely in the UK, and to directly influence the work of the ICS.   It should be the role of the ICS, and State of the Art, to reflect the issues that concern you in your daily practice, and which overseas meetings cannot cover in as much depth.
    • We have multiprofessional delegates, and should build on this: last year’s workforce session focussed on the numerical challenges for medical staffing in future, which (to me) suggests that next year’s should be about the scope for development in nursing, AHP, and critical care practitioner roles.  If this matters to you (and this should include intensivists as well as non-medics), then bring yourself, and your views.
  • Innovation: we already have a track record of creative formats and content – thanks in large part to the Trainee Committee.  The Cauldron aroused great interest last year, and the Pecha Kucha session (a trendy Japanese term for a paced, brief presentation of 20 slides in 20 seconds each) made for a lively atmosphere.  The latter could perhaps do with some explanatory labelling (PK 20×20?) for those of us previously flummoxed by the name:  I must admit that I spent most of the year convinced that it was named after a wealthy – possibly Finnish – industrialist donor, or perhaps a trainee who had died young under tragic circumstances; but now I know better. In any case, we should build on ideas like this for the wider meeting.
  • Technology: thanks to the trainees, the Secretariat, and my predecessors on the committee, we already have an advanced online presence with daily blogs, in-conference tweets and live speaker questions, and a Twitter wall.   This is excellent; and we can go further.  Suggestions already received include podcast interviews with key speakers before, during, and after the meeting; and an online conference forum set up in advance where the delegates can raise key issues they would like addressed, and participate in conference planning.

I think the art will be to combine all of these; to mix the classical approach to big conferences and the strengths of a national society, with the brightest and best new ideas, formats and content.  This is especially important at a time when events set up by the emerging pioneers of open-access critical care education, are busy re-writing the rules of what critical care conferences can be.  SMACC has doubled in size with every iteration, and the organisers are expecting several thousand delegates in Chicago in June (one of whom will be me).  Meanwhile Rob Mac Sweeney’s Critical Care Reviews meeting has just taken place in Northern Ireland, and received rave reviews from those attending. New-wave events like this are firstly an amazing achievement and deserve congratulation, but also, they quite rightly set a high bar for the established societies, and provide an opportunity for us to learn and improve.

We should be guided by their success and as a first step toward this, I am delighted that Rob has agreed to chat, advise and participate (once he has caught up on sleep…) while Steve Mathieu – well known to Wessex trainees for his educational activities and internationally though WessexICS and The Bottom Line blog; and the equally active Jonathan Downham of Critical Care Practitioner – have also kindly agreed to get involved in State of the Art and join us in the planning.  Oli Flower of the SMACC team has also (at time of writing) kindly been in touch, with discussions to follow.  These are early days, and it would be wrong to trumpet these emerging links too loudly until we see how things develop, but it would be nice to think that State of the Art might lead the way in blurring the boundaries between the so-far separate worlds of traditional medical conferences on the one hand, and the trailblazers of free open-access medical education on the other.

Moving beyond content and style, we need to talk about the venue.

Rather like those who first saw the Beatles in the Cavern, many of us – myself included – have fond memories of going to State of the Art at the Metropole and at the various venues outside London, along with the vanished charms of ISICEM’s early days in its original venue, and ESICM when it was small enough to visit a variety of smaller cities (my favouite was Stockholm).  However, success and growth comes at a price, and Increasing attendance has meant that all these meetings have had to move to larger congress centres in the larger cities, and State of the Art is no exception.

Excel is hypermodern, comfortable, and with excellent auditorium and AV facilities, (going by the TripAdvisor test) is reasonably highly rated by the general public; but as a State of the Art venue it gets decidedly mixed reviews.  So why are we there?  Firstly, of course, there is that warm charitable glow that comes from contributing to the impoverished widows and orphans of, um, the Abu Dhabi sovereign wealth fund, who own the place.  Well, perhaps not.  More pertinently, though, we have substantially outgrown the Metropole, and we are not yet large enough to make the bigger venues such as the QEII conference centre in Westminster economic (though BTS colleagues tell me the latter is not without its disadvantages).  For your interest, the venue hire for Excel is approximately £127,000, while the total cost base of the meeting is close to £400,000.  This includes office and staff overheads which support the entire meetings activity of the ICS, much of which is free to trainees.  In other words, moving to a less economic venue would be at the expense of either reducing other ICS educational activity, or higher entry prices for the conference.  Neither prospect pleases, especially at a time when sponsorship is down as industry and pharma cut back their own expenses.  Previous committees spent a lot of time looking into alternatives, before concluding that Excel is the best package for the moment.

Does this mean that nothing can be addressed or changed?  Not at all.

We are acutely aware that you are yourselves being increasingly squeezed for study leave allocation and funding, so it’s only fair that if we want you to come to State of the Art, we need to make the environment as attractive as we can, as well as making the content as lively as possible. This is where your feedback (whether through survey, or just by talking to us) is critically important, as a lot of the points that you have raised can be addressed.

  • Catering.  Contractually we have to use Excel’s catering options, and the eye-watering cost of a catered lunch (you’d think they fly the stuff in from the Emirates) means we can’t add it to the registration fee without you lynching us: but we can try to make things more user-friendly.  Last year the ICS team ensured that 8 food venues were open in 2014 compared to 3 in 2013; and for this year we will look into having stands nearer to the conference area.  In addition, two Industry Partner seminar slots were vacant this year for logistical reasons, meaning fewer industry lunch meetings.   This has been fixed for 2015, and Anna Wong at ICS HQ is putting a lot of work into getting a full sponsor complement.  If the slots are all taken, then there will be sponsored loaves and fishes aplenty on the relevant days.  We’ll work on breakfast too, but no promises yet.
  • Location, location, location.  For those in London, Excel is relatively – perhaps even disappointingly – manageable: I live in the West of the city, and my somewhat feeble attempts to justify a nice lie-in and breakfast in the speakers’ hotel, came to an abrupt end when my wife pointed out that the trip from Ealing is actually quicker than her daily commute into UCL, and that maybe I should just come home and put the bins out.   However, for out-of-town visitors hoping for the bright lights of London in December, the Docklands at night can seem a bit like a Mars colony, rather than a slice of the cultural capital of the world.  We can help.  Would you like us to include some hotels in town, along with the existing options?  Excel is actually only 20 min, with one line change, from Green Park or Westminster, so a hotel in the centre of town – which we can book for you – would give you a bit of proper London in the evenings, and an easy commute the next day.  This is what many of us do when in Berlin or Barcelona in any case.  Is this a step forward, or a daft idea?  Answers on a postcard, please.   We will continue to have some options close to the venue for those that want them.
  • Ambience.  The layout of the conference space currently consists of a couple of busy trade stand areas and a lot of empty corridors, lacking that cosy ability to bump into and chat with people which makes conferences fun.  Shaba Haque is meeting the Excel management shortly to debrief from 2014; we’ll follow this up with a site visit together to, essentially, rearrange the furniture.  Soft furnishings aren’t my area of expertise, but we think it should be quite possible to get a better and more sociable layout of posters, sitting areas, and circulation spaces, to give more of a networking buzz.   In addition, we plan to re-introduce an ICS Members’ area and speakers’ room (ideas which were brought up last year, but which there was insufficient time to enact).  Give us your further suggestions, and we will try to design them in.  ‘Kevin McCloud’ is our middle name.

Finally, as already mentioned, the SOA team and I would like to hear from you directly on all these issues.  The earlier, the better, as most elements of planning will be getting locked down by March.

Your feedback from 2014 has already been very useful, but we would like more than this: we would like your active involvement in planning 2015.  Give us ideas which we can use, and we’ll make sure you’re credited.

Consultation on SOA 2015: https://www.surveymonkey.com/s/ICSSOA2015

Every completed survey (if name and contact supplied – optional) will be entered into a draw for your choice of either a free full 3-day pass for this year’s conference, or one year’s free ICS membership, including JICS, free personal transfer accident insurance, and Affinity discount scheme including 10% off Apple and other products.

And/or please contact me personally with your feedback and suggestions: 

Email: ganesh.suntharalingam@nhs.net

Twitter: @Ganesh_ICM or @ICSmeetings

Mobile: please contact by one of the above means for my number.