A national survey of intensive care follow-up clinics in Australia

Abstract

Introduction: Post-Intensive Care Syndrome is prevalent among survivors of critical illness and can severely impact quality of life of patients and their families. To address this growing health care challenge, it has been suggested that patients should receive ongoing follow-up after discharge from the intensive care unit (ICU) and even hospital. Different care models exist, including intensive care follow-up clinics (ICFCs). ICFCs are being increasingly implemented globally, but Australian data is scarce. Study objectives: Primary objective was to determine the proportion of Australian ICUs which offer a dedicated ICFC. Secondary objectives were to identify models of in- and outpatient ICU follow-up and barriers to the implementation of ICFCs. Methods: A custom designed, pilot-tested twelve-question online survey was created, and a link emailed to the nurse unit managers and medical directors of the 167 Australian ICUs contained in the database of the Australia and New Zealand Intensive Care Society. Results: Out of 107 intensive care units which responded to the survey (response rate 64%) nine, most of which were tertiary, offered some form of outpatient follow-up. Two operated a dedicated ICFC, three conducted telephone follow-up and four followed patients-up as part of research studies. 67% of outpatient follow-up services were nursing and 11% medical led. 56% were unfunded and 33% were funded through the research budget. Only one service received dedicated funding. The main reason given for not operating an ICFC were financial constraints (58%), followed by lack of clinical need (19%) and perceived lack of evidence (11%). Conclusion: In Australia only two ICUs operated an ICFC. Only one outpatient follow-up service received dedicated funding and financial constraints were the main reason given for units not offering outpatient follow-up services.