Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?

Joanne McPeake; Leanne M. Boehm; Elizabeth Hibbert; Rita N. Bakhru; Anthony J. Bastin; Brad W. Butcher; Tammy L. Eaton; Wendy Harris; Aluko A. Hope; James Jackson; Annie Johnson; Janet A. Kloos; Karen A. Korzick; Pamela MacTavish; Joel Meyer; Ashley Montgomery-Yates; Tara Quasim; Andrew Slack; Dorothy Wade; Mary Still; Giora Netzer; Ramona O. Hopkins; Mark E. Mikkelsen; Theodore J. Iwashyna; Kimberley J. Haines; Carla M. Sevin

doi:10.1097/CCE.0000000000000088

Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?

Joanne McPeake, Leanne M. Boehm, Elizabeth Hibbert, Rita N. Bakhru, Anthony J. Bastin, Brad W. Butcher, Tammy L. Eaton, Wendy Harris, Aluko A. Hope, James Jackson, Annie Johnson, Janet A. Kloos, Karen A. Korzick, Pamela MacTavish, Joel Meyer, Ashley Montgomery-Yates, Tara Quasim, Andrew Slack, Dorothy Wade, Mary StillGiora Netzer, Ramona O. Hopkins, Mark E. Mikkelsen, Theodore J. Iwashyna, Kimberley J. Haines, Carla M. Sevin

Internal Medicine

Research output: Contribution to journal › Article › peer-review

83 Scopus citations

Abstract

Objectives: To understand from the perspective of patients who did, and did not attend ICU recovery programs, what were the most important components of successful programs and how should they be organized. Design: International, qualitative study. Setting: Fourteen hospitals in the United States, United Kingdom, and Australia. Patients: We conducted 66 semi-structured interviews with a diverse group of patients, 52 of whom had used an ICU recovery program and 14 whom had not. Interventions: None. Measurements and Main Results: Using content analysis, prevalent themes were documented to understand what improved their outcomes. Contrasting quotes from patients who had not received certain aspects of care were used to identify perceived differential effectiveness. Successful ICU recovery programs had five key components: 1) Continuity of care; 2) Improving symptom status; 3) Normalization and expectation management; 4) Internal and external validation of progress; and 5) Reducing feelings of guilt and helplessness. The delivery of care which achieved these goals was facilitated by early involvement (even before hospital discharge), direct involvement of ICU staff, and a focus on integration across traditional disease, symptom, and social welfare needs. Conclusions: In this multicenter study, conducted across three continents, patients identified specific and reproducible modes of benefit derived from ICU recovery programs, which could be the target of future intervention refinement.

Original language	English
Pages (from-to)	E0088
Journal	Critical Care Explorations
Volume	2
Issue number	4
DOIs	https://doi.org/10.1097/CCE.0000000000000088
State	Published - Apr 7 2020

Bibliographical note

Publisher Copyright:
© 2020 The Authors. Published by Wolters Kluwer Health, Inc.

Funding

Drs. McPeake’s, Boehm’s, Hibbert’s, Bastin’s, Johnson’s, Montgomery-Yates’s, Quasim’s, Haines’s, and Sevin’s institutions received funding from the Society of Critical Care Medicine. Dr. McPeake’s, Dr. Quasim’s, and Mrs. MacTavish’s institutions received funding from the Health Foundation (United Kingdom). Drs. Boehm’s (K12 HL137943) and Hope’s institutions received funding from the American Association of Critical-Care Nurses and the National Heart, Lung, and Blood Institute. Drs. Boehm, Hope, and Jackson received support for article research from the National Institutes of Health. Dr. Iwashyna disclosed government work (K12 HL138039). The remaining authors have disclosed that they do not have any potential conflicts of interest.

Funders	Funder number
National Heart, Lung, and Blood Institute (NHLBI)
Society of Critical Care Medicine
American Association of Critical-Care Nurses
American Health Assistance Foundation/National Heart Foundation	K12 HL137943

Keywords

intensive care unit follow-up clinics
peer support
post-intensive care syndrome

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine

Access to Document

10.1097/CCE.0000000000000088

Cite this

McPeake, J., Boehm, L. M., Hibbert, E., Bakhru, R. N., Bastin, A. J., Butcher, B. W., Eaton, T. L., Harris, W., Hope, A. A., Jackson, J., Johnson, A., Kloos, J. A., Korzick, K. A., MacTavish, P., Meyer, J., Montgomery-Yates, A., Quasim, T., Slack, A., Wade, D., ... Sevin, C. M. (2020). Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit? Critical Care Explorations, 2(4), E0088. https://doi.org/10.1097/CCE.0000000000000088

@article{36172c847da74dc88d8cd96af7df4382,

title = "Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?",

abstract = "Objectives: To understand from the perspective of patients who did, and did not attend ICU recovery programs, what were the most important components of successful programs and how should they be organized. Design: International, qualitative study. Setting: Fourteen hospitals in the United States, United Kingdom, and Australia. Patients: We conducted 66 semi-structured interviews with a diverse group of patients, 52 of whom had used an ICU recovery program and 14 whom had not. Interventions: None. Measurements and Main Results: Using content analysis, prevalent themes were documented to understand what improved their outcomes. Contrasting quotes from patients who had not received certain aspects of care were used to identify perceived differential effectiveness. Successful ICU recovery programs had five key components: 1) Continuity of care; 2) Improving symptom status; 3) Normalization and expectation management; 4) Internal and external validation of progress; and 5) Reducing feelings of guilt and helplessness. The delivery of care which achieved these goals was facilitated by early involvement (even before hospital discharge), direct involvement of ICU staff, and a focus on integration across traditional disease, symptom, and social welfare needs. Conclusions: In this multicenter study, conducted across three continents, patients identified specific and reproducible modes of benefit derived from ICU recovery programs, which could be the target of future intervention refinement.",

keywords = "intensive care unit follow-up clinics, peer support, post-intensive care syndrome",

author = "Joanne McPeake and Boehm, \{Leanne M.\} and Elizabeth Hibbert and Bakhru, \{Rita N.\} and Bastin, \{Anthony J.\} and Butcher, \{Brad W.\} and Eaton, \{Tammy L.\} and Wendy Harris and Hope, \{Aluko A.\} and James Jackson and Annie Johnson and Kloos, \{Janet A.\} and Korzick, \{Karen A.\} and Pamela MacTavish and Joel Meyer and Ashley Montgomery-Yates and Tara Quasim and Andrew Slack and Dorothy Wade and Mary Still and Giora Netzer and Hopkins, \{Ramona O.\} and Mikkelsen, \{Mark E.\} and Iwashyna, \{Theodore J.\} and Haines, \{Kimberley J.\} and Sevin, \{Carla M.\}",

note = "Publisher Copyright: {\textcopyright} 2020 The Authors. Published by Wolters Kluwer Health, Inc.",

year = "2020",

month = apr,

day = "7",

doi = "10.1097/CCE.0000000000000088",

language = "English",

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McPeake, J, Boehm, LM, Hibbert, E, Bakhru, RN, Bastin, AJ, Butcher, BW, Eaton, TL, Harris, W, Hope, AA, Jackson, J, Johnson, A, Kloos, JA, Korzick, KA, MacTavish, P, Meyer, J, Montgomery-Yates, A, Quasim, T, Slack, A, Wade, D, Still, M, Netzer, G, Hopkins, RO, Mikkelsen, ME, Iwashyna, TJ, Haines, KJ & Sevin, CM 2020, 'Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?', Critical Care Explorations, vol. 2, no. 4, pp. E0088. https://doi.org/10.1097/CCE.0000000000000088

TY - JOUR

T1 - Key Components of ICU Recovery Programs

T2 - What Did Patients Report Provided Benefit?

AU - McPeake, Joanne

AU - Boehm, Leanne M.

AU - Hibbert, Elizabeth

AU - Bakhru, Rita N.

AU - Bastin, Anthony J.

AU - Butcher, Brad W.

AU - Eaton, Tammy L.

AU - Harris, Wendy

AU - Hope, Aluko A.

AU - Jackson, James

AU - Johnson, Annie

AU - Kloos, Janet A.

AU - Korzick, Karen A.

AU - MacTavish, Pamela

AU - Meyer, Joel

AU - Montgomery-Yates, Ashley

AU - Quasim, Tara

AU - Slack, Andrew

AU - Wade, Dorothy

AU - Still, Mary

AU - Netzer, Giora

AU - Hopkins, Ramona O.

AU - Mikkelsen, Mark E.

AU - Iwashyna, Theodore J.

AU - Haines, Kimberley J.

AU - Sevin, Carla M.

PY - 2020/4/7

Y1 - 2020/4/7

N2 - Objectives: To understand from the perspective of patients who did, and did not attend ICU recovery programs, what were the most important components of successful programs and how should they be organized. Design: International, qualitative study. Setting: Fourteen hospitals in the United States, United Kingdom, and Australia. Patients: We conducted 66 semi-structured interviews with a diverse group of patients, 52 of whom had used an ICU recovery program and 14 whom had not. Interventions: None. Measurements and Main Results: Using content analysis, prevalent themes were documented to understand what improved their outcomes. Contrasting quotes from patients who had not received certain aspects of care were used to identify perceived differential effectiveness. Successful ICU recovery programs had five key components: 1) Continuity of care; 2) Improving symptom status; 3) Normalization and expectation management; 4) Internal and external validation of progress; and 5) Reducing feelings of guilt and helplessness. The delivery of care which achieved these goals was facilitated by early involvement (even before hospital discharge), direct involvement of ICU staff, and a focus on integration across traditional disease, symptom, and social welfare needs. Conclusions: In this multicenter study, conducted across three continents, patients identified specific and reproducible modes of benefit derived from ICU recovery programs, which could be the target of future intervention refinement.

AB - Objectives: To understand from the perspective of patients who did, and did not attend ICU recovery programs, what were the most important components of successful programs and how should they be organized. Design: International, qualitative study. Setting: Fourteen hospitals in the United States, United Kingdom, and Australia. Patients: We conducted 66 semi-structured interviews with a diverse group of patients, 52 of whom had used an ICU recovery program and 14 whom had not. Interventions: None. Measurements and Main Results: Using content analysis, prevalent themes were documented to understand what improved their outcomes. Contrasting quotes from patients who had not received certain aspects of care were used to identify perceived differential effectiveness. Successful ICU recovery programs had five key components: 1) Continuity of care; 2) Improving symptom status; 3) Normalization and expectation management; 4) Internal and external validation of progress; and 5) Reducing feelings of guilt and helplessness. The delivery of care which achieved these goals was facilitated by early involvement (even before hospital discharge), direct involvement of ICU staff, and a focus on integration across traditional disease, symptom, and social welfare needs. Conclusions: In this multicenter study, conducted across three continents, patients identified specific and reproducible modes of benefit derived from ICU recovery programs, which could be the target of future intervention refinement.

KW - intensive care unit follow-up clinics

KW - peer support

KW - post-intensive care syndrome

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Key Components of ICU Recovery Programs: What Did Patients Report Provided Benefit?

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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