Characteristics of Post-ICU and Post-COVID Recovery Clinics in 29 US Health Systems

被引：47

作者：

Danesh, Valerie ^{[1
]}

Boehm, Leanne M. ^{[2
,3
]}

Eaton, Tammy L. ^{[4
,5
]}

Arroliga, Alejandro C. ^{[6
,7
]}

Mayer, Kirby P. ^{[8
]}

Kesler, Shelli R. ^{[9
]}

Bakhru, Rita N. ^{[10
]}

Baram, Michael ^{[11
]}

Bellinghausen, Amy L. ^{[12
]}

Biehl, Michelle ^{[13
]}

Dangayach, Neha S. ^{[14
]}

Goldstein, Nir M. ^{[15
]}

Hoehn, K. Sarah ^{[16
]}

Islam, Marjan ^{[17
]}

Jagpal, Sugeet ^{[18
]}

Johnson, Annie B. ^{[19
]}

Jolley, Sarah E. ^{[20
]}

Kloos, Janet A. ^{[21
]}

Mahoney, Eric J. ^{[22
]}

Maley, Jason H. ^{[23
]}

Martin, Sara F. ^{[24
]}

Mcsparron, Jakob I. ^{[25
]}

Mery, Marissa ^{[26
]}

Saft, Howard ^{[27
]}

Santhosh, Lekshmi ^{[28
]}

Schwab, Kristin ^{[29
]}

Villalba, Dario ^{[30
]}

Sevin, Carla M. ^{[31
]}

Montgomery, Ashley A. ^{[32
]}

机构：

[1] Baylor Scott & White Res Inst, Ctr Appl Hlth Res, Dallas, TX 75204 USA

[2] Vanderbilt Univ, Sch Nursing, Nashville, TN USA

[3] Vanderbilt Univ Sch Med, Crit Illness Brain Dysfunct & Survivorship CIBS Ct, Nashville, TN USA

[4] Univ Michigan, Natl Clinician Scholars Program, Ann Arbor, MI USA

[5] UPMC Mercy Hosp, Div Crit Care Med, Pittsburgh, PA USA

[6] Dept Pulm & Crit Care Med, Baylor Scott & White Hlth, Dallas, TX USA

[7] Texas A&M Univ, Coll Med, College Stn, TX USA

[8] Univ Kentucky, Dept Phys Therapy, Lexington, KY USA

[9] Univ Texas Austin, Sch Nursing, Austin, TX USA

[10] Wake Forest Sch Med, Dept Internal Med, Winston Salem, NC USA

[11] Thomas Jefferson Univ, Dept Med, Philadelphia, PA USA

[12] Univ Calif San Diego, Dept Pulm Crit Care & Sleep Med, San Diego, CA USA

[13] Cleveland Clin, Dept Pulm & Crit Care Med, Cleveland, OH USA

[14] Icahn Sch Med Mt Sinai, Dept Neurosurg, New York, NY USA

[15] Natl Jewish Hlth, Dept Med, Denver, CO USA

[16] Univ Chicago, Dept Pediat, Chicago, IL USA

[17] Albert Einstein Coll Med, Dept Med, Montefiore Med Ctr, Bronx, NY USA

[18] Rutgers Robert Wood Johnson Med Sch, Dept Med, New Brunswick, NJ USA

[19] Mayo Clin, Crit Care, Rochester, MN USA

[20] Univ Colorado, Dept Crit Care Med, Anschutz, CO USA

[21] Univ Hosp Cleveland Med Ctr, Dept Acute & Crit Care Nursing, Cleveland, OH USA

[22] Tufts Med Ctr, Dept Surg, Boston, MA USA

[23] Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA USA

[24] Vanderbilt Univ Sch Med, Dept Palliat Care & Internal Med, Nashville, TN USA

[25] Univ Michigan, Dept Pulm & Crit Care Med, Ann Arbor, MI USA

[26] Univ Texas Austin, Dept Anesthesiol, Med Sch, Austin, TX USA

[27] Natl Jewish Hlth, Dept Pulm & Crit Care Med, Denver, CO USA

[28] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

[29] Univ Calif Los Angeles, Dept Med, Los Angeles, CA USA

[30] Hosp Chivilcoy, Dept Resp Care, Chivilcoy, Argentina

[31] Vanderbilt Univ Sch Med, Dept Med, Nashville, TN USA

[32] Univ Kentucky, Dept Pulm Crit Care & Sleep Med, Lexington, KY USA

来源：

CRITICAL CARE EXPLORATIONS | 2022年 / 4卷 / 03期

关键词：

administration; healthcare delivery; postacute sequelae of COVID-19; postintensive care syndrome; severe acute respiratory syndrome coronavirus-2; MEDICATION MANAGEMENT; CARE; IMPLEMENTATION; EPIDEMIOLOGY; GUIDELINES; COHORT; MODEL;

D O I：

10.1097/CCE.0000000000000658

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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.

引用

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