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Crit Care Med. 2019 Jan;47(1):e21-e27. doi: 10.1097/CCM.0000000000003497.

Models of Peer Support to Remediate Post-Intensive Care Syndrome: A Report Developed by the Society of Critical Care Medicine Thrive International Peer Support Collaborative.

Author information

1
NHS Greater Glasgow and Clyde, Glasgow, United Kingdom.
2
University of Glasgow, Glasgow, United Kingdom.
3
Center for Humanizing Critical Care, Intermountain Healthcare, Murray, UT.
4
Division of Pulmonary and Critical Care, Department of Medicine, University of Utah, Salt Lake City, UT.
5
Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT.
6
Dell Children's Medical Centre, Austin, TX.
7
VA Tennessee Valley Healthcare System, Nashville, TN.
8
Western Health, Melbourne, VIC, Australia.
9
Australia and New Zealand Intensive Care Society Research Centre, Monash University, Melbourne, VIC, Australia.
10
Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA.
11
Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
12
University College London Hospitals NHS Foundation Trust, London, United Kingdom.
13
Society of Critical Care Medicine, Chicago, IL.
14
Pulmonary, Critical Care, Allergy & Immunologic Diseases, Wake Forest School of Medicine, Winston Salem, NC.
15
Vanderbilt University Medical Center, Nashville, TN.
16
Intermountain Medical Center, Division of Pulmonary and Critical Care, Murray, UT.
17
Division of Pulmonary and Critical Care, University of Utah, Salt Lake City, UT.
18
Vanderbilt University School of Nursing, Nashville, TN.
19
VA Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center, Nashville, TN.
20
Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University, Nashville, TN.
21
NorthShore University HealthSystem, Chicago, IL.
22
Duke University School of Medicine, Durham, NC.
23
Evanston Hospital, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Chicago, IL.
24
Alfred Health, Melbourne, VIC, Australia.
25
Jay B Langer Critical Care System, New York, NY.
26
Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT.
27
Critical Care Unit, University College London NHS Foundation Trust, London, United Kingdom.
28
Mayo Clinic, Rochester, MN.
29
Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA.
30
Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA.
31
Division of Pulmonary and Critical Care Medicine, Brigham & Women's Hospital, Boston, MA.
32
NorthShore University Health System - Evanston Hospital, Chicago, IL.
33
Beth Israel Deaconess Medical Center, Boston, MA.
34
Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine of the University of Pennsylvania, Pennsylvania, PA.
35
University Hospitals Cleveland Medical Center, Cleveland, OH.
36
Division of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
37
Emory University Hospital (Emory Healthcare), Atlanta, GA.
38
College of Nursing, University of Kentucky, Lexington, KY.
39
Division of Respirology, Department of Medicine, Toronto Western Hospital, Toronto, ON, Canada.
40
Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, MI.
41
Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.

Abstract

OBJECTIVES:

Patients and caregivers can experience a range of physical, psychologic, and cognitive problems following critical care discharge. The use of peer support has been proposed as an innovative support mechanism.

DESIGN:

We sought to identify technical, safety, and procedural aspects of existing operational models of peer support, among the Society of Critical Care Medicine Thrive Peer Support Collaborative. We also sought to categorize key distinctions between these models and elucidate barriers and facilitators to implementation.

SUBJECTS AND SETTING:

Seventeen Thrive sites from the United States, United Kingdom, and Australia were represented by a range of healthcare professionals.

MEASUREMENTS AND MAIN RESULTS:

Via an iterative process of in-person and email/conference calls, members of the Collaborative defined the key areas on which peer support models could be defined and compared, collected detailed self-reports from all sites, reviewed the information, and identified clusters of models. Barriers and challenges to implementation of peer support models were also documented. Within the Thrive Collaborative, six general models of peer support were identified: community based, psychologist-led outpatient, models-based within ICU follow-up clinics, online, groups based within ICU, and peer mentor models. The most common barriers to implementation were recruitment to groups, personnel input and training, sustainability and funding, risk management, and measuring success.

CONCLUSIONS:

A number of different models of peer support are currently being developed to help patients and families recover and grow in the postcritical care setting.

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