1103: MULTIDISCIPLINARY ICU RECOVERY CLINIC VISITS: QUALITATIVE ANALYSIS OF PATIENT-PROVIDER INTERACTIONS

Abstract

Introduction: Research confirms the heterogeneous nature of patient challenges during Intensive Care Unit (ICU) recovery and supports the need for modifying care experiences, but there are little data guiding clinicians seeking to support individualized recovery trajectories for patients. Thus, we evaluated the content of patient-provider interactions during a telemedicine multidisciplinary ICU Recovery Clinic (ICU-RC) visit to better understand support needs. Methods: We conducted a qualitative descriptive study in a telemedicine multidisciplinary ICU-RC at a tertiary academic medical center in the Southeastern United States. The sample included 17 patients and 13 care partners (>=18 years) attending a telemedicine ICU-RC visit following a critical illness due to sepsis or acute respiratory failure. Patients and care partners met with an ICU pharmacist, ICU physician, and a psychologist via a secure web-conferencing platform for 31 ICU-RC visits within 12 weeks of hospital discharge. Telemedicine ICU-RC visits were audio-recorded and transcribed verbatim for analysis. A coding system was developed using iterative inductive and deductive approaches. Results: Two themes were identified from the patient-provider dialogue: 1) problem identification and 2) problem-solving strategies. We identified five subthemes that capture problem identification: health status, mental health and cognition, medication management, health care access and navigation, and quality of life. Problem-solving subthemes included facilitating care coordination and transitions (e.g., inter-provider communication, medication refills), education (e.g., information resources), and anticipatory guidance (e.g., clarifying misconceptions). Patient-provider dialogue illustrated the interactive nature of finding and solving problems during an ICU-RC visit. The ICU-RC visit provided teachable moments to impact health and prevent future problems. Conclusions: The content and interactions between patients and clinicians in our sample convey the depth and breadth of problems found and problems solved in a multidisciplinary telemedicine ICU-RC. Our analysis provided a fuller description of post-hospital ICU aftercare, and how ICU clinicians can identify recovery problems, decrease fragmentation, and promote follow-up care after a critical illness.