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1. Improving Critical Care Survivorship : A Guide to Prevention, Recovery, and Reintegration

Author

Kimberley J. Haines, Joanne McPeake, Carla M. Sevin, Kimberley J. Haines, Joanne McPeake, and Carla M. Sevin

Subjects
Intensive care units, Critical care medicine
Abstract

This book provides a comprehensive overview of improving critical care survivorship. Comprised of four sections, the text presents interventions that can be used to improve patient outcomes and reduce the burden of post-intensive care syndrome across the arc of care, from the ICU to returning home. The first section of the text focuses on preventing adverse outcomes in the ICU, with an emphasis on implementing early mobilization, engaging and supporting families, and employing various forms of therapy. The second section revolves around enhancing recovery post-ICU, focusing on physical and neurocognitive rehabilitation programs, peer support, and poly-pharmacy management. Community reintegration is the subject of the third section, with emphasis on socioeconomic reintegration, healthcare utilization, and volunteerism in ICU recovery. The book concludes with a section on future considerations, specifically spotlighting preliminary ideas that address long-term sequelae and international collaboration to solve critical care challenges. Written by experts in the field, Improving Critical Care Survivorship: A Guide for Prevention, Recovery, and Reintegration is a valuable resource for critical care clinicians and researchers interested in improving the quality of patient survival after ICU admission.

Published
2021

2. Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives

Author

Jessica Whitten, Leanne M. Boehm, Rita N. Bakhru, Ramona O. Hopkins, Clare Holdsworth, Kelly Drumright, Brad W. Butcher, Krishna Aparanji, Babar A. Khan, Kimberley J Haines, Thomas Farley, Annie Johnson, Theodore J. Iwashyna, Joanna L. Stollings, Joanne McPeake, Andrew Fritschle, Joel Meyer, Carla M. Sevin, Howard L. Saft, Mark E. Mikkelsen, Andrew Slack, Penelope Firshman, Aluko A. Hope, Giora Netzer, Pamela MacTavish, Tara Quasim, Gerald L. Weinhouse, Sarah J. Beesley, Ashley Montgomery-Yates, Janet A. Kloos, Elizabeth Hibbert, Tammy L. Eaton, Erin K. Kross, Anthony J. Bastin, Michael T. Kenes, and Belinda MacLeod-Smith

Subjects
Adult, Male, medicine.medical_specialty, Quality management, Critical Care, Attitude of Health Personnel, Original, Pain medicine, health care facilities, manpower, and services, Declaration, Aftercare, Intensive care unit follow-up clinics, Peer support, Critical Care and Intensive Care Medicine, Post-intensive care syndrome, Feedback, law.invention, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Nursing, law, Anesthesiology, Patient experience, Or education, Medicine, Humans, Family, Survivors, Qualitative Research, Patient Care Team, business.industry, 030208 emergency & critical care medicine, Middle Aged, Quality Improvement, Intensive care unit, Focus group, 3. Good health, Intensive Care Units, 030228 respiratory system, Patient Satisfaction, Key (cryptography), Female, business, Psychology, Subacute Care
Abstract

Objective: Identify the key mechanisms which clinicians perceive improve care in the intensive care unit (ICU), as a result of their involvement in post ICU programs. Methods: Qualitative inquiry via focus groups and interviews with members of the Society of Critical Care Medicine's Thrive collaboratives from over 20 centres in the UK, Australia and US (follow-up clinics and peer support). Framework Analysis was used to synthesize and interpret the data. Results: Five key mechanisms were identified as drivers of improvement back into the ICU: 1) Identifying otherwise unseen targets for ICU quality improvement or education programs - new ideas for quality improvement were generated and greater attention paid to detail in clinical care. 2) Creating a new role for survivors in the ICU - former patients and family members adopted an advocacy or peer volunteer role. 3) Inviting critical care providers to the post-ICU program to educate, sensitize, and motivate them - clinician peers and trainees were invited to attend as a helpful learning strategy to gain insights into post-ICU care requirements. 4) Changing clinician's own understanding of patient experience - there appeared to be a direct individual benefit from working in post-ICU programs. 5) Improving morale and meaningfulness of ICU work - this was achieved by closing the feedback loop to ICU clinicians regarding patient and family outcomes. Conclusions: The follow-up of patients and families in post-ICU care settings is perceived to improve care within the ICU via five key mechanisms. Further testing of whether these mechanisms drive improvements in patient and family-centered care, and whether these programs enhance clinician well-being and ICU culture, is warranted. Funding Statement: K Haines, J McPeake, L Boehm, C Sevin and Tara Quasim are currently receiving funding from SCCM to undertake this work. L Boehm is funded by NIH/NHLBI (K12 HL137943) as is T J Iwashyna (K12 HL138039). Declaration of Interests: : K Haines, J McPeake, L Boehm, C Sevin and Tara Quasim are currently receiving funding from SCCM to undertake this work. L Boehm is funded by NIH/NHLBI (K12 HL137943) as is T J Iwashyna (K12 HL138039). No conflicts of interest declared by other authors. Ethics Approval Statement: The institutional ethics committee of the principal investigator (KH) approved the study (HREC/17/WH/170) and consent was implied through participation.

Published
2019

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