ICU Follow-up Clinics

Abstract

Survivors of critical illness face a range of challenges to recovery, including new deficits in physical, emotional and cognitive function, fragmented health care systems, socioeconomic burdens, and insufficient rehabilitation support. Critical illness is complex, and transitions of care over the course of recovery are many. Multidisciplinary ICU recovery programs such as ICU follow-up clinics can address specific sequelae of critical illness and critical care, and may promote better recovery. Many questions about ICU follow-up remain unanswered. Key components of ICU follow-up clinics, identification of patients best served by these clinics, timing, and potential disciplines involved may vary. Serial assessments may be required. In addition to intensivists, pharmacists, nurses, psychologists, physical therapists, occupational therapists, speech therapists, nutritionists, and social workers are employed in ICU follow-up clinics. Peer support may be integrated into or adjacent to an ICU follow-up clinic. The ICU follow-up clinic may be a setting in which to address or readdress goals of care after critical illness. Leveraging technology such as telemedicine to reach more patients and families may assist clinicians to address disparities in survivorship and overcome logistical barriers to attendance. The possible impacts of ICU follow-up clinics are myriad: readmissions, healthcare utilization, morbidity, and mortality are high after critical illness. Additional targets for ICU follow-up clinics include patient satisfaction, quality improvement, burnout reduction, and medical education. But, barriers to implementation and sustained operation of ICU follow-up clinics remain, and must be addressed both clinically, and through additional research.