Haines, K. J. et al. (2019) Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives. Intensive Care Medicine, 45(7), pp. 939-947. (doi: 10.1007/s00134-019-05647-5) (PMID:31165227) (PMCID:PMC6611738)
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Abstract
Objective: To identify the key mechanisms that 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 collaborative sites (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 research is required in this novel area.
Item Type: | Articles |
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Additional Information: | 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). |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Quasim, Professor Tara and McPeake, Dr Jo |
Authors: | Haines, K. J., Sevin, C. M., Hibbert, E., Boehm, L. M., Aparanji, K., Bakhru, R. N., Bastin, A. J., Beesley, S. J., Butcher, B. W., Drumright, K., Eaton, T. L., Farley, T., Firshman, P., Fritschle, A., Holdsworth, C., Hope, A., Johnson, A., Kenes, M. T., Khan, B. A., Kloos, J. A., Kross, E. K., MacLeod-Smith, B. J., Mactavish, P., Meyer, J., Montgomery-Yates, A., Quasim, T., Saft, H., Slack, A., Stollings, J., Weinhouse, G., Whitten, J., Netzer, G., Hopkins, R. O., Mikkelsen, M. E., Iwashyna, T. J., and McPeake, J. |
College/School: | College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care |
Journal Name: | Intensive Care Medicine |
Publisher: | Springer |
ISSN: | 0342-4642 |
ISSN (Online): | 1432-1238 |
Published Online: | 04 June 2019 |
Copyright Holders: | Copyright © 2019 The Authors |
First Published: | First published in Intensive Care Medicine 45(7):939-947 |
Publisher Policy: | Reproduced under a Creative Commons License |
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