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Crit Care Med. 2014 Dec;42(12):2518-26. doi: 10.1097/CCM.0000000000000525.

Exploring the scope of post-intensive care syndrome therapy and care: engagement of non-critical care providers and survivors in a second stakeholders meeting.

Author information

1
1Faculty of Health, University of Technology Sydney, NSW, Australia. 2EBP and Research Nurse Liaison, UCSD Medical Center, San Diego, CA. 3Department of Clinical Practice, American Physical Therapy Association, Alexandria, VA. 4Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, UT. 5Department of Psychology and Neuroscience, Brigham Young University, Provo, UT. 6Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI. 7Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA. 8Department of Medicine, University of Minnesota, Minneapolis, MN. 9Department of Anesthesia and Epidemiology, Columbia University, New York, NY. 10Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD. 11Swallowing and Voice Center at Marianjoy Rehabilitation Hospital, Wheaton, IL. 12Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD. 13Department of Anesthesiology and Critical Care and Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 14Illinois Chapter, American Case Management Association, Chicago, IL. 15Sepsis Alliance, San Diego, CA. 16Summa Health System/Pharmacy Practice, Northeast Ohio Medical University (NEOMED), Akron, OH. 17Division of Orthopedic Surgery and Rehabilitation, Schwab Rehabilitation Hospital, University of Chicago, Chicago, IL. 18Department of Standards and Survey Methods, Division of Healthcare Quality Evaluation, The Joint Commission, Washington, D.C. 19Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI. 20Critical Care and Respiratory Care, Kaiser Westside Medical Center, Hillsboro, OR. 21Department of Care Management/Social Services, NorthShore University Health System, Evanston, IL. 22Society for Social Work Leadership in Health Care, Social Work Arkan

Abstract

BACKGROUND:

Increasing numbers of survivors of critical illness are at risk for physical, cognitive, and/or mental health impairments that may persist for months or years after hospital discharge. The post-intensive care syndrome framework encompassing these multidimensional morbidities was developed at the 2010 Society of Critical Care Medicine conference on improving long-term outcomes after critical illness for survivors and their families.

OBJECTIVES:

To report on engagement with non-critical care providers and survivors during the 2012 Society of Critical Care Medicine post-intensive care syndrome stakeholder conference. Task groups developed strategies and resources required for raising awareness and education, understanding and addressing barriers to clinical practice, and identifying research gaps and resources, aimed at improving patient and family outcomes.

PARTICIPANTS:

Representatives from 21 professional associations or health systems involved in the provision of both critical care and rehabilitation of ICU survivors in the United States and ICU survivors and family members.

DESIGN:

Stakeholder consensus meeting. Researchers presented summaries on morbidities for survivors and their families, whereas survivors presented their own experiences.

MEETING OUTCOMES:

Future steps were planned regarding 1) recognizing, preventing, and treating post-intensive care syndrome, 2) building strategies for institutional capacity to support and partner with survivors and families, and 3) understanding and addressing barriers to practice. There was recognition of the need for systematic and frequent assessment for post-intensive care syndrome across the continuum of care, including explicit "functional reconciliation" (assessing gaps between a patient's pre-ICU and current functional ability at all intra- and interinstitutional transitions of care). Future post-intensive care syndrome research topic areas were identified across the continuum of recovery: characterization of at-risk patients (including recognizing risk factors, mechanisms of injury, and optimal screening instruments), prevention and treatment interventions, and outcomes research for patients and families.

CONCLUSIONS:

Raising awareness of post-intensive care syndrome for the public and both critical care and non-critical care clinicians will inform a more coordinated approach to treatment and support during recovery after critical illness. Continued conceptual development and engagement with additional stakeholders is required.

PMID:
25083984
DOI:
10.1097/CCM.0000000000000525
[Indexed for MEDLINE]
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