Enablers and Barriers to Implementing ICU Follow-Up Clinics and Peer Support Groups Following Critical Illness: The Thrive Collaboratives.

Autor:	Haines KJ; Department of Physiotherapy, Western Health, Melbourne, VIC, Australia.; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia., McPeake J; Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Scotland, United Kingdom.; School of Medicine, Dentistry and Nursing, University of Glasgow, Scotland, United Kingdom., Hibbert E; Department of Physiotherapy, Western Health, Melbourne, VIC, Australia., Boehm LM; School of Nursing, Vanderbilt University, Nashville, TN., Aparanji K; Critical Care Medicine, Springfield Clinic, Springfield, IL., Bakhru RN; Wake Forest University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, Allergy and Immunology, Winston Salem, NC., Bastin AJ; Department of Peri-operative Medicine, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom., Beesley SJ; Pulmonary Division, Department of Medicine, Intermountain Medical Center, Murray, UT.; Center for Humanizing Critical Care, Intermountain Health Care, Murray, UT.; Pulmonary Division, Department of Medicine, University of Utah, Salt Lake City, UT., Beveridge L; Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Scotland, United Kingdom., Butcher BW; Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA., Drumright K; Tennessee Valley Healthcare System VA Medical Center, Nashville, TN., Eaton TL; Palliative and Supportive Institute, UPMC Mercy, Pittsburgh, PA., Farley T; School of Nursing, University of California San Francisco, San Francisco, CA., Firshman P; Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom., Fritschle A; Department of Pharmacy, Eskenazi Health, Indianapolis, IN., Holdsworth C; Department of Physiotherapy, Western Health, Melbourne, VIC, Australia., Hope AA; Division of Critical Care Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY., Johnson A; CCRN Mayo Clinic, Rochester, MN., Kenes MT; Department of Pharmacy, Wake Forest Baptist Medical Center, Winston Salem, NC., Khan BA; Indiana University School of Medicine Research Scientist, Regenstrief Institute Inc., Indianapolis, IN., Kloos JA; University Hospitals Cleveland Medical Center, Cleveland, OH., Kross EK; Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Harborview Medical Center, University of Washington, Seattle, WA., Mactavish P; Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Scotland, United Kingdom., Meyer J; Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom., Montgomery-Yates A; Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, KY., Quasim T; Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Scotland, United Kingdom., Saft HL; Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO., Slack A; Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom., Stollings J; Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN., Weinhouse G; Department of Medicine, Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA., Whitten J; Department of Pharmacy, Eskenazi Health, Indianapolis, IN., Netzer G; Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD., Hopkins RO; Center for Humanizing Critical Care, Intermountain Health Care, Murray, UT.; Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, UT.; Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT., Mikkelsen ME; Division of Pulmonary, Allergy, and Critical Care Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA., Iwashyna TJ; Department of Medicine, Division of Pulmonary & Critical Care, University of Michigan, Ann Arbor, MI.; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI., Sevin CM; Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
Jazyk:	angličtina
Zdroj:	Critical care medicine [Crit Care Med] 2019 Sep; Vol. 47 (9), pp. 1194-1200.
DOI:	10.1097/CCM.0000000000003818
Abstrakt:	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.
Databáze:	MEDLINE
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