critical illness, post-intensive care syndrome, peer support, intensive care unit, follow-up clinics
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.
Critical Care Medicine
Family, Home, and Social Sciences
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