Post-ICU Clinic Follow-Up for Reducing Doctor Burnout

Overseen By Jakob McSparron, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Death during ICU stay

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how meetings between ICU patients and their doctors after discharge might reduce doctor burnout. It focuses on fostering ongoing relationships between doctors who provided critical care and patients who survived serious illnesses. The trial examines whether these "encounter visits with patients" improve doctors' job satisfaction and reduce stress levels. Patients referred to a special follow-up clinic after their ICU stay might be suitable candidates. As an unphased trial, this study offers patients a unique opportunity to contribute to enhancing healthcare provider well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this protocol is safe for reducing doctor burnout?

Research has shown that meeting with patients after intensive care is safe and helpful. Studies on clinics that see patients post-ICU suggest these visits improve follow-up care without major safety issues. For instance, research on these clinics found that follow-ups are well-organized and effective across various healthcare systems worldwide. This indicates that having medical residents meet with former ICU patients is generally safe and does not cause harm.

While these meetings mainly benefit doctors and medical trainees, there have been no significant reports of problems during these visits. This suggests the process is safe for both healthcare providers and patients. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a novel approach to reducing doctor burnout by focusing on post-ICU care. Traditionally, treatments for doctor burnout might include stress management workshops or wellness programs, but this trial is unique because it involves residents meeting with ICU patients during follow-up visits. This face-to-face interaction could provide valuable closure and emotional connection, potentially decreasing stress and burnout. By examining how direct patient encounters after ICU care affect residents, researchers hope to uncover a simple yet effective method to improve doctors' well-being and job satisfaction.

What evidence suggests that this trial's treatments could be effective in reducing doctor burnout?

Research has shown that clinics for patients after ICU care can help reduce burnout in healthcare workers. In this trial, some residents will meet ICU patients during follow-up visits. Studies suggest that these interactions can lower stress and improve mental health for ICU teams. One study indicated that meeting with patients after their ICU stay can increase healthcare workers' satisfaction and reduce burnout. These meetings help build strong relationships, potentially enhancing how they feel about their work in critical care. Overall, evidence supports the idea that follow-up visits positively affect healthcare providers. Meanwhile, other residents in this trial will not meet with patients, allowing for a comparison of outcomes between the two groups. ^{1 2 3 6 7}

Who Is on the Research Team?

Jakob McSparron, MD

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for healthcare providers who have completed at least one 2-week rotation in the medical ICU at the University of Michigan and cared for a patient enrolled in this study. It's focused on those eligible or referred to Post ICU Longitudinal Survivor Experience (PULSE) clinic follow-up.

Inclusion Criteria

Patients must be eligible for Post ICU Longitudinal Survivor Experience (PULSE) clinic follow up and/or have received referral to clinic

Residents must have completed at least one 2-week rotation in the medical ICU at the University of Michigan

Residents must have cared for an enrolled patient in the study

Exclusion Criteria

Patients who died during ICU stay

Residents who provided only 'cross-cover' for the patient

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Follow-up Visit

Residents meet ICU patients during a follow-up visit to assess the impact on professional fulfillment and burnout

1 day

1 visit (in-person)

Post-Visit Assessment

Assessment of changes in Professional Fulfillment and Burnout Scales approximately 14 days after the follow-up visit

2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Encounter visit with Patients
• Non-encounter surveys

Trial Overview

The trial examines the impact of post-ICU clinic visits between patients and their previous critical care providers on provider burnout and professional fulfillment. The goal is to see if these encounters improve long-term relationships and perceptions of critical care.

How Is the Trial Designed?

Group I: Residents meet ICU patients during follow-up visit (encounter) Experimental Treatment 1 Intervention

Residents will be paired according to the patient that were cared.

Group II: Residents in the non-encounter group Experimental Treatment 1 Intervention

Residents will not meet with patients that were in the ICU.

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

Published Research Related to This Trial

Intensive care unit follow-up clinics are essential for helping survivors of critical illness recover from post-intensive care syndrome, addressing their physical, cognitive, psychiatric, and social needs.

Successfully establishing these clinics requires overcoming challenges such as securing adequate resources, assembling a dedicated multidisciplinary team, and effectively identifying patients who will benefit from the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meeting the Challenges of Establishing Intensive Care Unit Follow-up Clinics. Butcher, BW., Eaton, TL., Montgomery-Yates, AA., et al.[2023]

Former ICU patients highly value follow-up services, as these contribute significantly to their physical and emotional recovery by providing continuity of care, expert reassurance, and important information about their recovery process.

Many patients felt abandoned without access to follow-up care, highlighting a gap in healthcare services; however, they also recognized the financial constraints of the health system and were selective about continuing follow-up appointments based on their perceived needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What patients think about ICU follow-up services: a qualitative study. Prinjha, S., Field, K., Rowan, K.[2022]

A pilot study involving 42 ICU survivors with type 2 diabetes showed that outcomes after 6 months were poor, with high mortality (26%) and only 47% living independently without support.

The shared-care clinic did not significantly improve key health measures like glycated hemoglobin or quality of life compared to usual care, suggesting that a larger trial with this design may not be feasible due to low participation and high mortality rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Survivors of Intensive Care With Type 2 Diabetes and the Effect of Shared-Care Follow-Up Clinics: The SWEET-AS Randomized Controlled Pilot Study. Ali Abdelhamid, Y., Phillips, LK., White, MG., et al.[2021]

In a study of 83 patients discharged from intensive care, nearly 75% experienced identifiable safety threats, highlighting significant risks in post-ICU care.

The most common safety threats were medication errors (27%) and inadequate medical follow-up (25%), with 41% of these threats deemed preventable, suggesting that improved monitoring and support could enhance patient safety after ICU discharge.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identification of Patient Safety Threats in a Post-Intensive Care Clinic. Karlic, KJ., Valley, TS., Cagino, LM., et al.[2023]

Follow-up assessments of patients discharged from the ICU are crucial for evaluating the quality of care, as they provide insights beyond just survival rates, helping to identify areas for improvement in critical care practices.

The study utilized a nurse-administered questionnaire to gather information on functional outcomes and psychological issues experienced by patients shortly after discharge, highlighting the importance of addressing anxiety and sleep disturbances in post-ICU care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immediate follow-up after ICU discharge: establishment of a service and initial experiences. Strahan, E., Mccormick, J., Uprichard, E., et al.[2019]

Post-ICU clinics can enhance medical learners' education by allowing them to follow patients' recovery journeys, which helps them understand long-term outcomes and the impact of intensive care.

These clinics may also reduce compassion fatigue and burnout among trainees by providing opportunities for reflection and quality improvement in ICU care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Beyond the ICU Rotation: The Importance of Trainee Involvement in Post-Intensive Care Unit Clinics. Ohnigian, SE., Hall, MM., Hayes, MM., et al.[2022]

Intensive care follow-up clinics have emerged to better understand the long-term impacts of critical illness on patients and their families, moving beyond just mortality statistics to focus on broader patient-centered outcomes.

Research is beginning to quantify the postdischarge challenges faced by patients, highlighting the importance of these clinics in improving the quality of life after intensive care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical review: Intensive care follow-up--what has it told us? Broomhead, LR., Brett, SJ.[2022]

The PINA study is a pilot randomized controlled trial involving 100 ICU patients aimed at evaluating the feasibility and potential efficacy of a follow-up clinic designed to support ICU survivors suffering from post-intensive care syndrome (PICS).

The intervention includes providing information, consultations, and networking support to improve health-related quality of life (HRQOL) for patients, with outcomes assessed at 6 months post-discharge.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Piloting an ICU follow-up clinic to improve health-related quality of life in ICU survivors after a prolonged intensive care stay (PINA): study protocol for a pilot randomised controlled trial. Rohr, M., Brandstetter, S., Bernardi, C., et al.[2021]

Follow-up sessions after ICU discharge help clarify and confirm patients' experiences, providing valuable information that many found previously unclear, indicating their efficacy in post-ICU care.

Patients who received psychosocial support after ICU discharge reported better experiences than those who did not, highlighting the importance of integrating mental health support into post-ICU care to address patients' needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The experiences of ICU patients during follow-up sessions--a qualitative study. Haraldsson, L., Christensson, L., Conlon, L., et al.[2016]

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