Kimberley J. Haines, Sunshine Hospital
Carla M. Sevin, Vanderbilt University Medical Center
Elizabeth Hibbert, Western Health
Leanne M. Boehme, Vanderbilt University
Krishna Aparanji, Springfeld Clinic
Rita N. Bakhru, Wake Forest University School of Medicine
Anthony J. Bastin, Barts Health NHS Trust
Sarah J. Beesley, Intermountain Medical Center
Brad W. Butcher, University of Pittsburgh Medical Center
Kelly Drumright, Tennessee Valley Healthcare System VA Medical Center
Tammy L. Eaton, University of Pittsburgh Medical Center
Thomas Farley, University of California San Francisco
Penelope Firshman, Guy’s and St Thomas’ NHS Foundation Trust
Andrew Fritschle, Eskenazi Health
Clare Holdsworth, Western Health
Aluko A. Hope, Albert Einstein College of Medicine of Yeshiva University
Annie Johnson, Mayo Clinic
Michael T. Kenes, Wake Forest Baptist Medical Center
Babar A. Khan, Regenstrief Institute Inc.
Janet A. Kloos, University Hospitals Cleveland Medical Center
Erin K. Kross, University of Washington
Belinda J. MacLeod‑Smith, Safer Care Victoria
Pamela Mactavish, y, NHS Greater Glasgow and Clyde
Joel Meyer, Guy’s and St Thomas’ NHS Foundation Trust
Ashley Montgomery‑Yates, University of Kentucky
Tara Quasim, NHS Greater Glasgow and Clyde
Howard L. Saft, National Jewish Health
Andrew Slack, Guy’s and St Thomas’ NHS Foundation Trust
Joanna Stollings, Vanderbilt University Medical Center
Gerald Weinhouse, Brigham and Women’s Hospital
Jessica Whitten, Eskenazi Health
Giora Netzer, University of Maryland School of Medicine
Ramona O. HopkinsFollow
Mark E. Mikkelsen, Hospital of the University of Pennsylvania
Theodore J. Iwashyna, University of Michigan
Joanne McPeake, University of Glasgow


Post-intensive care syndrome, Intensive care unit follow-up clinics, Peer support


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 inter‑ pret the data.

Results: Five key mechanisms were identifed as drivers of improvement back into the ICU: (1) identifying other‑ wise 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 understand‑ ing of patient experience—there appeared to be a direct individual beneft 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 fve key mechanisms. Further research is required in this novel area.

Original Publication Citation

Intensive Care Med (2019) 45:939–947

Document Type

Peer-Reviewed Article

Publication Date







Family, Home, and Social Sciences



University Standing at Time of Publication

Full Professor

Included in

Psychology Commons