ENABLERS AND BARRIERS TO IMPLEMENTING ICU FOLLOWUP CLINICS AND PEER SUPPORT GROUPS FOLLOWING CRITICAL ILLNESS: THE THRIVE COLLABORATIVES

Authors

• Kimberely J. Haines PhD, BHSc (Physiotherapy), Western Health
• Joanne McPeake PhD, MSc, BN (Hons), RGN, NHS Greater Glasgow and Clyde
• Elizabeth Hibbert B.Physiotherapy, Western Health
• Leanne M. Boehm PhD, RN, ACNS-BC, Vanderbilt University
• Krishna Aparanji MD, CPE, Springfield Clinic
• Rita N. Bakhru MD, MS, Wake Forest University School of Medicine
• Anthony J. Bastin MBBS PhD, Barts Health NHS Trust
• Sarah J. Beesley MD, MSc, Intermountain Medical Center
• Lynne Beveridge RGN, NHS Greater Glasgow and Clyde
• Brad W. Butcher MD, University of Pittsburgh Medical Center
• Kelly Drumright MSN, RN, CNL, Tennessee Valley Healthcare System VA Medical Center
• Tammy L. Eaton MSN, RN, FNP-BC, ACHPN, UPMC Mercy
• Thomas Farley MS, ACNP, University of California San Francisco
• Penelope Firshman BSc, Guy’s and St Thomas’ NHS Foundation Trust London
• Andrew Fritschle PharmD, Eskenazi Health
• Clare Holdsworth BPhys (Hons), Western Health
• Aluko A. Hope MD, MSCE, Albert Einstein College of Medicine of Yeshiva University
• Annie Johnson APRN, ACNP-BC, CCRN Mayo Clinic
• Michael T. Kenes PharmD, BCPS, BCCCP, Wake Forest Baptist Medical Center
• Babar A. Khan MD, MS, Regenstrief Institute Inc.
• Janet A. Kloos RN, PhD, APRN-CCNS, CCRN, University Hospitals Cleveland Medical Center
• Erin K. Kross MD, University of Washington
• Pamela Mactavish BSc Pharm (Hons) MSc.,, NHS Greater Glasgow and Clyde
• Joel Meyer BM BCh DM, Guy’s & St Thomas’ NHS Foundation Trust
• Ashley Montgomery-Yates MD, University of Kentucky
• Tara Quasim MBChB, MD, NHS Greater Glasgow and Clyde
• Howard L. Saft MD, MS, National Jewish Health
• Andrew Slack MBBS, MRCP, EDIC, MD (Res), Guy’s & St Thomas’ NHS Foundation Trust
• Joanna Stollings PharmD, FCCM, FCCP, Vanderbilt University Medical Center
• Gerald Weinhouse MD, Brigham and Women’s Hospital
• Jessica Whitten PharmD, Eskenazi Health
• Giora Netzer MD, MSCE, University of Maryland School of Medicine
• Ramona O. Hopkins PhD, Brigham Young University - ProvoFollow
• Mark E. Mikkelsen MD, MSCE, Hospital of the University of Pennsylvania
• Theodore J. Iwashyna MD, PhD, University of Michigan
• Carla M. Sevin MD, Vanderbilt University Medical Center

Keywords

critical illness, post-intensive care syndrome, peer support, intensive care unit, follow-up clinics

Abstract

Objective: Data are lacking regarding implementation of novel strategies such as follow-up clinics and peer support groups, to reduce the burden of post-intensive care syndrome. We sought to discover enablers that helped hospital-based clinicians establish post-ICU clinics and peer support programs, and identify barriers that challenged them.

Design: Qualitative inquiry. The Consolidated Framework for Implementation Research was used to organize and analyze data.

Setting: Two learning collaboratives (ICU follow-up clinics and peer support groups), representing 23 sites, across three continents.

Subjects: Clinicians from 23 sites. Measurement and Main Results: Ten enablers and nine barriers to implementation of ICU follow-up clinics were described. A key enabler to generate support for clinics was providing insight into the human experience of survivorship, to obtain interest from hospital administrators. Significant barriers included patient and family lack of access to clinics and clinic funding. Nine enablers and five barriers to the implementation of peer support groups were identified. Key enablers included developing infrastructure to support successful operationalization of this complex intervention, flexibility about when peer support should be offered, belonging to the international learning collaborative. Significant barriers related to limited attendance by patients and families due to challenges in creating awareness, and uncertainty about who might be appropriate to attend and target in advertising.

Conclusions: Several enablers and barriers to implementing ICU follow-up clinics and peer support groups should be taken into account and leveraged to improve ICU recovery. Among the most important enablers are motivated clinician leaders who persist to find a path forward despite obstacles.

Original Publication Citation

Crit Care Med. 2019 September ; 47(9): 1194–1200. doi:10.1097/CCM.0000000000003818

BYU ScholarsArchive Citation

Haines, Kimberely J. PhD, BHSc (Physiotherapy); McPeake, Joanne PhD, MSc, BN (Hons), RGN; Hibbert, Elizabeth B.Physiotherapy; Boehm, Leanne M. PhD, RN, ACNS-BC; Aparanji, Krishna MD, CPE; Bakhru, Rita N. MD, MS; Bastin, Anthony J. MBBS PhD; Beesley, Sarah J. MD, MSc; Beveridge, Lynne RGN; Butcher, Brad W. MD; Drumright, Kelly MSN, RN, CNL; Eaton, Tammy L. MSN, RN, FNP-BC, ACHPN; Farley, Thomas MS, ACNP; Firshman, Penelope BSc; Fritschle, Andrew PharmD; Holdsworth, Clare BPhys (Hons); Hope, Aluko A. MD, MSCE; Johnson, Annie APRN, ACNP-BC; Kenes, Michael T. PharmD, BCPS, BCCCP; Khan, Babar A. MD, MS; Kloos, Janet A. RN, PhD, APRN-CCNS, CCRN; Kross, Erin K. MD; Mactavish, Pamela BSc Pharm (Hons) MSc.,; Meyer, Joel BM BCh DM; Montgomery-Yates, Ashley MD; Quasim, Tara MBChB, MD; Saft, Howard L. MD, MS; Slack, Andrew MBBS, MRCP, EDIC, MD (Res); Stollings, Joanna PharmD, FCCM, FCCP; Weinhouse, Gerald MD; Whitten, Jessica PharmD; Netzer, Giora MD, MSCE; Hopkins, Ramona O. PhD; Mikkelsen, Mark E. MD, MSCE; Iwashyna, Theodore J. MD, PhD; and Sevin, Carla M. MD, "ENABLERS AND BARRIERS TO IMPLEMENTING ICU FOLLOWUP CLINICS AND PEER SUPPORT GROUPS FOLLOWING CRITICAL ILLNESS: THE THRIVE COLLABORATIVES" (2019). Faculty Publications. 6304.
https://scholarsarchive.byu.edu/facpub/6304

Document Type

Peer-Reviewed Article

Publication Date

2019-09-01

Publisher

Critical Care Medicine

Language

English

College

Family, Home, and Social Sciences

Department

Psychology

University Standing at Time of Publication

Full Professor

Copyright Use Information

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