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

Trial Summary

What is the purpose of this trial?

This study is being conducted to describe the impact of a meeting between patients that were admitted to the intensive care unit (ICU) and a provider that cared for the patients during the period of critical illness. The study team is aiming to describe the effect this meeting has on the physician that previously cared for the patient. The study team hypothesizes that facilitating involvement in post-ICU clinic and creating longitudinal relationships between providers of critical care and survivors of critical illness will have positive effects on trainees, both in professional fulfillment and burnout scores and in perceptions of critical care.

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 data supports the effectiveness of the treatment Post-ICU Clinic Follow-Up for Reducing Doctor Burnout?

Research suggests that post-ICU clinics can enhance provider satisfaction and reduce burnout by allowing healthcare providers to engage in long-term patient care, reflection, and quality improvement, which can mitigate compassion fatigue. ^{1 2 3 4 5}

Is it safe to participate in a post-ICU follow-up clinic?

Post-ICU follow-up clinics have identified safety threats such as medication errors and delayed medical follow-up, but many of these issues are preventable or can be improved. Nearly 75% of patients in these clinics experienced some safety threat, highlighting the importance of careful management and follow-up. ^{1 3 6 7 8}

How is the Post-ICU Clinic Follow-Up treatment different from other treatments for reducing doctor burnout?

The Post-ICU Clinic Follow-Up treatment is unique because it involves ongoing care and monitoring of patients after they leave the ICU, which not only supports patient recovery but also helps reduce doctor burnout by providing medical staff with feedback and reflection opportunities. This approach is different from standard treatments as it focuses on long-term patient outcomes and the well-being of healthcare providers. ^{1 2 3 6 9}

Research Team

Jakob McSparron, MD

Principal Investigator

University of Michigan

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Beyond the ICU Rotation: The Importance of Trainee Involvement in Post-Intensive Care Unit Clinics. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Immediate follow-up after ICU discharge: establishment of a service and initial experiences. [2019]

3. England 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. [2021]

4. Netherlands pubmed.ncbi.nlm.nih.gov

The experiences of ICU patients during follow-up sessions--a qualitative study. [2016]

5. England pubmed.ncbi.nlm.nih.gov

Clinical review: Intensive care follow-up--what has it told us? [2022]

6. United States 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. [2021]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Identification of Patient Safety Threats in a Post-Intensive Care Clinic. [2023]

8. England pubmed.ncbi.nlm.nih.gov

What patients think about ICU follow-up services: a qualitative study. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Meeting the Challenges of Establishing Intensive Care Unit Follow-up Clinics. [2023]