Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/35144
Title: CLINICIAN AND PATIENT IDENTIFIED SOLUTIONS TO REDUCE THE FRAGMENTATION OF POST-ICU CARE IN AUSTRALIA.
Austin Authors: Leggett, Nina;Emery, Kate;Rollinson, Thomas C ;Deane, Adam M;French, Craig;Manski-Nankervis, Jo-Anne;Eastwood, Glenn M ;Miles, Briannah;Witherspoon, Sophie;Stewart, Jonathan;Merolli, Mark;Ali Abdelhamid, Yasmine;Haines, Kimberley J 
Affiliation: Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia; Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia.
Physiotherapy
Department of Intensive Care, Melbourne Health; Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Intensive Care, Western Health, Melbourne, Victoria, Australia.
Department of General Practice and Primary Care, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
Intensive Care
Department of Intensive Care, Melbourne Health, Melbourne, Victoria, Australia.
Mount Isa Base Hospital, Mount Isa, Queensland, Australia.
Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland.
Dept of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne; Centre for Digital Transformation of Health, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Intensive Care, Royal Melbourne Hospital; Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Physiotherapy, Western Health, Australia; Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Institute for Breathing and Sleep
Issue Date: 19-Feb-2024
Date: 2024
Publication information: Chest 2024-02-19
Abstract: Critical care survivors experience multiple care transitions, with no formal follow-up care pathway. What are the potential solutions to improve the communication between treating teams and integration of care following an Intensive Care Unit (ICU) admission - from the perspective of patients, their caregivers, intensivists, and General Practitioners (GPs) from diverse socioeconomic areas? & Methods: Qualitative design using semi-structured interviews with intensivists, GPs, and patients and caregivers. Framework Analysis was used to analyse data, and to identify solutions to improve the integration of care post-hospital discharge. Patients were previously mechanically ventilated for >24 hours in ICU and had access to a video-enabled device. Clinicians were recruited from hospital networks and a state-wide GP network. Forty-six interviews with clinicians, patients and caregivers were completed (15 Intensivists, 8 GPs, 15 patients and 8 caregivers). Three higher-level feedback loops were identified, that comprised of ten themes. Feedback loop 1: ICU and primary care collaboration: 1. Developing collaborative relationships between the ICU and primary care, 2. Providing interprofessional education and resources to support primary care, 3. Improving role clarity for patient follow-up care; Feedback loop 2: Developing mechanisms for improved communication across the care continuum: 4. Timely, concise information sharing with primary care on post-ICU recovery, 5. Survivorship focused information sharing across the continuum of care, 6. Empowering patients and caregivers in self-management; 7. Creation of a care coordinator role for survivors; and Feedback loop 3: Learning from post-ICU outcomes to improve future care: 8. Developing comprehensive post-ICU care pathways, 9. Enhancing support for patients after hospital, 10. Integration of post-ICU outcomes within the ICU to improve clinician morale and understanding. Practical solutions to enhance the quality of survivorship for critical care survivors and their caregivers were identified. These themes are mapped to a novel conceptual model that includes key feedback loops for health system improvements and foci for future interventional trials to improve ICU survivorship outcomes.
URI: https://ahro.austin.org.au/austinjspui/handle/1/35144
DOI: 10.1016/j.chest.2024.02.019
ORCID: 
Journal: Chest
PubMed URL: 38382876
ISSN: 1931-3543
Type: Journal Article
Subjects: Aftercare
LIST
critical care
general practice
primary care
qualitative
recovery
Appears in Collections:Journal articles

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