@article{b9fabec4a0e44874b74c74d84dcd151d,
title = "Enablers and barriers to implementing ICU follow-up clinics and peer support groups following critical illness: The thrive collaboratives",
abstract = "Objectives: Data are lacking regarding implementation of novel strategies such as follow-up clinics and peer support groups, to reduce the burden of postintensive 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 21 sites, across three continents. Subjects: Clinicians from 21 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.",
keywords = "Critical illness, Follow-up clinics, Intensive care unit, Peer support, Postintensive care syndrome",
author = "Haines, {Kimberley J.} and Joanne McPeake and Elizabeth Hibbert and Boehm, {Leanne M.} and Krishna Aparanji and Bakhru, {Rita N.} and Bastin, {Anthony J.} and Beesley, {Sarah J.} and Lynne Beveridge and Butcher, {Brad W.} and Kelly Drumright and Eaton, {Tammy L.} and Thomas Farley and Penelope Firshman and Andrew Fritschle and Clare Holdsworth and Hope, {Aluko A.} and Annie Johnson and Kenes, {Michael T.} and Khan, {Babar A.} and Kloos, {Janet A.} and Kross, {Erin K.} and Pamela MacTavish and Joel Meyer and Ashley Montgomery-Yates and Tara Quasim and Saft, {Howard L.} and Andrew Slack and Joanna Stollings and Gerald Weinhouse and Jessica Whitten and Giora Netzer and Hopkins, {Ramona O.} and Mikkelsen, {Mark E.} and Iwashyna, {Theodore J.} and Sevin, {Carla M.}",
note = "Funding Information: institution received funding from NHLBI K01-HL140279, and he received The Society of Critical Care Medicine (SCCM) Thrive ini-tution received funding from the NIH. Dr. Kross{\textquoteright}s institution received fundingfunding from American Association of Critical Care Nurses. Dr. Khan{\textquoteright}s insti- tiative implemented two international learning collaboratives from the NIH and the American Lung Association. Dr. Quasim{\textquoteright}s institution (8) to facilitate rapid identification of strategies to improve received funding from the Health Foundation. Dr. Saft received funding from outcomes for ICU survivors and their families. With the po-Weinhouse received funding from UptoDate. Dr. Hopkins{\textquoteright}s institution re-Medtronic. Dr. Stollings received funding from Intermountain Health. Dr. tential to reduce psychologic distress among survivors and ceived funding from Intermountain Research and Medical Foundation. Dr. their families, improve care coordination, augment support, government work. The remaining authors have disclosed that they do notIwashyna{\textquoteright}s institution received funding from NIH K12, and he disclosed and facilitate recovery through optimized management and/ have any potential conflicts of interest. or self-management, the Thrive post-ICU clinics collaborative For information regarding this article, E-mail: Kimberley.haines@wh.org.au (9) was launched in 2017, and the peer support collaborative (7, 10) in 2015. Funding Information: Stollings{\textquoteright}s, and Sevin{\textquoteright}s institutions received funding from the Society ofDrumright{\textquoteright}s, Holdsworth{\textquoteright}s, Johnson{\textquoteright}s, Kloos{\textquoteright}s, Meyer{\textquoteright}s, Quasim{\textquoteright}s, Saft{\textquoteright}s, Survivors of critical illness—both patients and their fam-Critical Care Medicine (SCCM). Drs. Haines, McPeake, Boehm, and Sevin ilies—face a wide range of challenges (1–4). Despite a are currently receiving funding from SCCM to undertake this work, although growing number of clinical trials designed to improve ysis, besides approving the final article for submission for publication. Dr.the supporting source had no input into the design, data collection and anal- long-term outcomes after critical illness, postintensive care Boehm{\textquoteright}s institution received funding from the National Institutes of Health syndrome and postintensive care syndrome family are all too (NIH)/National Heart, Lung, and Blood Institute (NHLBI) (1K12HL137943- common (5, 6). As care coordination for survivors is presently source reviewed and approved the article for submission. Drs. Boehm and01) and Vanderbilt Clinical and Translational Science Award. The funding lacking, novel strategies have been called for to bridge the gap Iwashyna received support for article research from the NIH. Dr. Hope{\textquoteright}s that survivors experience (7). Publisher Copyright: {\textcopyright} 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.",
year = "2019",
doi = "10.1097/CCM.0000000000003818",
language = "English (US)",
volume = "47",
pages = "1194--1200",
journal = "Critical care medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "9",
}