Resumen
OBJECTIVES: The multifaceted long-term impairments resulting from critical illness and COVID-19 require interdisciplinary management approaches in the recovery phase of illness. Operational insights into the structure and process of recovery clinics (RCs) from heterogeneous health systems are needed. This study describes the structure and process characteristics of existing and newly implemented ICU-RCs and COVID-RCs in a subset of large health systems in the United States. DESIGN: Cross-sectional survey. SETTING: Thirty-nine RCs, representing a combined 156 hospitals within 29 health systems participated. PATIENTS: None. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: RC demographics, referral criteria, and operating characteristics were collected, including measures used to assess physical, psychologic, and cognitive recoveries. Thirty-nine RC surveys were completed (94% response rate). ICU-RC teams included physicians, pharmacists, social workers, physical therapists, and advanced practice providers. Funding sources for ICU-RCs included clinical billing (n = 20, 77%), volunteer staff support (n = 15, 58%), institutional staff/space support (n = 13, 46%), and grant or foundation funding (n = 3, 12%). Forty-six percent of RCs report patient visit durations of 1 hour or longer. ICU-RC teams reported use of validated scales to assess psychologic recovery (93%), physical recovery (89%), and cognitive recovery (86%) more often in standard visits compared with COVID-RC teams (psychologic, 54%; physical, 69%; and cognitive, 46%). CONCLUSIONS: Operating structures of RCs vary, though almost all describe modest capacity and reliance on volunteerism and discretionary institutional support. ICU-and COVID-RCs in the United States employ varied funding sources and endorse different assessment measures during visits to guide care coordination. Common features include integration of ICU clinicians, interdisciplinary approach, and focus on severe critical illness. The heterogeneity in RC structures and processes contributes to future research on the optimal structure and process to achieve the best postintensive care syndrome and postacute sequelae of COVID outcomes.
| Idioma original | English |
|---|---|
| Páginas (desde-hasta) | E0658 |
| Publicación | Critical Care Explorations |
| Volumen | 4 |
| N.º | 3 |
| DOI | |
| Estado | Published - mar 9 2022 |
Nota bibliográfica
Publisher Copyright:© 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
Financiación
RC services are detailed in . In addition to physicians, teams included pharmacists (81%), social worker or case manager (58%), physical therapists (54%), and advanced practice providers (46%). Funding sources for ICU-RC operations included clinical billing (n = 20, 77%), volunteer staff support (n = 15, 58%), institutional staff/space support (n = 13, 46%), and grant or foundation funding (n = 3, 12%). One-third of ICU-RC sites report that both staff salaries and physical space allocations are supported by institutional funding. Only three of 26 ICU-RCs reported philanthropic funding and/or research grant funding as contributory to clinic operations. Most ICU-RC clinic visits were 31–120 minutes in duration (n = 19, 73%), with the remainder reporting visits greater than 2 hours (n = 6, 23%).
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine