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Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation
Morbidity after PICU admission for critical illness is a growing concern. Sequelae may occur in various domains of functioning and can only appropriately be determined through structured follow-up. Here, we describe the process of designing and implementing a structured multidisciplinary follow-up p...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226472/ https://www.ncbi.nlm.nih.gov/pubmed/36807306 http://dx.doi.org/10.1097/PCC.0000000000003213 |
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author | de Sonnaville, Eleonore S. V. van Woensel, Job B. M. van Goudoever, Johannes B. Otten, Marieke H. Teela, Lorynn Aarnoudse-Moens, Cornelieke S. H. Terheggen-Lagro, Suzanne W. J. van der Hulst, Annelies E. Engelen, Marc Kӧnigs, Marsh Oosterlaan, Jaap Knoester, Hennie |
author_facet | de Sonnaville, Eleonore S. V. van Woensel, Job B. M. van Goudoever, Johannes B. Otten, Marieke H. Teela, Lorynn Aarnoudse-Moens, Cornelieke S. H. Terheggen-Lagro, Suzanne W. J. van der Hulst, Annelies E. Engelen, Marc Kӧnigs, Marsh Oosterlaan, Jaap Knoester, Hennie |
author_sort | de Sonnaville, Eleonore S. V. |
collection | PubMed |
description | Morbidity after PICU admission for critical illness is a growing concern. Sequelae may occur in various domains of functioning and can only appropriately be determined through structured follow-up. Here, we describe the process of designing and implementing a structured multidisciplinary follow-up program for patients and their parents after PICU admission and show the first results illustrating the significance of our program. DESIGN: Prospective observational cohort study. SETTING: Outpatient PICU follow-up clinic. PATIENTS: Patients 0–18 years old admitted to our PICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In our structured multidisciplinary follow-up program, follow-up care is provided by a pediatric intensivist and psychologist and in addition, depending on patient’s critical illness and received PICU treatment(s), by a pediatric pulmonologist, cardiologist, neurologist, and/or neuropsychologist. All consultations are scheduled consecutively. Collected data are stored in a hospital-wide data warehouse and used for yearly health care evaluation sessions as well as scientific research. Challenges in organizing this follow-up program include technological challenges, providing time-efficient care, participation rate, and completeness of questionnaires. In our experience, a dedicated team is essential to tackle these challenges. Our first results, obtained in 307 of 388 referred patients (79.1%), showed the diversity of problems arising after PICU discharge, including physical, neurocognitive, and psychosocial sequelae. In addition, our data also reflected the risk of psychosocial problems among parents. Within the limited operation time of our follow-up program, the program has evolved based on our experiences and the data collected. CONCLUSIONS: We successfully developed and implemented a structured multidisciplinary follow-up program for patients and their parents after PICU admission. This program may help to timely initiate appropriate interventions, improve the standard of care during and after PICU admission, and facilitate scientific research on outcome and prognosis after PICU admission. |
format | Online Article Text |
id | pubmed-10226472 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-102264722023-05-30 Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation de Sonnaville, Eleonore S. V. van Woensel, Job B. M. van Goudoever, Johannes B. Otten, Marieke H. Teela, Lorynn Aarnoudse-Moens, Cornelieke S. H. Terheggen-Lagro, Suzanne W. J. van der Hulst, Annelies E. Engelen, Marc Kӧnigs, Marsh Oosterlaan, Jaap Knoester, Hennie Pediatr Crit Care Med Clinical Investigations Morbidity after PICU admission for critical illness is a growing concern. Sequelae may occur in various domains of functioning and can only appropriately be determined through structured follow-up. Here, we describe the process of designing and implementing a structured multidisciplinary follow-up program for patients and their parents after PICU admission and show the first results illustrating the significance of our program. DESIGN: Prospective observational cohort study. SETTING: Outpatient PICU follow-up clinic. PATIENTS: Patients 0–18 years old admitted to our PICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In our structured multidisciplinary follow-up program, follow-up care is provided by a pediatric intensivist and psychologist and in addition, depending on patient’s critical illness and received PICU treatment(s), by a pediatric pulmonologist, cardiologist, neurologist, and/or neuropsychologist. All consultations are scheduled consecutively. Collected data are stored in a hospital-wide data warehouse and used for yearly health care evaluation sessions as well as scientific research. Challenges in organizing this follow-up program include technological challenges, providing time-efficient care, participation rate, and completeness of questionnaires. In our experience, a dedicated team is essential to tackle these challenges. Our first results, obtained in 307 of 388 referred patients (79.1%), showed the diversity of problems arising after PICU discharge, including physical, neurocognitive, and psychosocial sequelae. In addition, our data also reflected the risk of psychosocial problems among parents. Within the limited operation time of our follow-up program, the program has evolved based on our experiences and the data collected. CONCLUSIONS: We successfully developed and implemented a structured multidisciplinary follow-up program for patients and their parents after PICU admission. This program may help to timely initiate appropriate interventions, improve the standard of care during and after PICU admission, and facilitate scientific research on outcome and prognosis after PICU admission. Lippincott Williams & Wilkins 2023-02-17 2023-06 /pmc/articles/PMC10226472/ /pubmed/36807306 http://dx.doi.org/10.1097/PCC.0000000000003213 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Clinical Investigations de Sonnaville, Eleonore S. V. van Woensel, Job B. M. van Goudoever, Johannes B. Otten, Marieke H. Teela, Lorynn Aarnoudse-Moens, Cornelieke S. H. Terheggen-Lagro, Suzanne W. J. van der Hulst, Annelies E. Engelen, Marc Kӧnigs, Marsh Oosterlaan, Jaap Knoester, Hennie Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation |
title | Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation |
title_full | Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation |
title_fullStr | Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation |
title_full_unstemmed | Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation |
title_short | Structured Multidisciplinary Follow-Up After Pediatric Intensive Care: A Model for Continuous Data-Driven Health Care Innovation |
title_sort | structured multidisciplinary follow-up after pediatric intensive care: a model for continuous data-driven health care innovation |
topic | Clinical Investigations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226472/ https://www.ncbi.nlm.nih.gov/pubmed/36807306 http://dx.doi.org/10.1097/PCC.0000000000003213 |
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