Insights from clinicians on reconnecting with survivors of critical illness: An international qualitative investigation.

Abstract

BACKGROUND: Over the last two decades multiple interventions have been implemented to support critical care survivors, each with limited success in improving quality of life and clinical outcomes. There has been limited evaluation of longitudinal critical illness recovery care, including any corresponding impact on the healthcare system or clinicians. The objective of this analysis was to explore the experience of clinicians reconnecting with survivors of critical illness and the subsequent impact that this reconnection was perceived to have within the healthcare system. METHODS: We conducted an international qualitative investigation using in-depth semi-structured interviews with clinicians from varied settings, including the UK National Health Service, USA Veteran Affairs, and USA Safety Net Hospitals. Clinicians represented different professional disciplines, specialities, and experience. Interviews were analysed using Framework Analysis. RESULTS: Nineteen clinicians were interviewed. Of those interviewed, 16 (84 %) were female, and the majority worked in critical care settings (n = 10, 53 %). In total, 16 healthcare system settings were represented across the interviews. Following the identification of how reconnection with survivors was operationalised, six themes were identified, and categorised into two domains. The first domain was the Impact of reconnection for clinicians and included: mitigation against emotional exhaustion; workplace meaning; and value placed on staff. The second domain was the Impact on the critical care system and care delivery and included humanisation of care delivery; richer insights to underpin decision-making; and the provision of data to drive improvements in care. CONCLUSIONS: This multi-centre international investigation suggests that there are potentially benefits for clinician wellbeing as well as the delivery of care within the critical care setting from reconnection between survivors of critical illness and clinicians. CLINICAL IMPLICATIONS: This research has explored the experience of reconnection between critical care survivors and clinicians from a clinician perspective. It has shown potential benefits for clinician wellbeing as well as the delivery of care within the critical care setting. Reconnection and how it could be incorporated into critical care services should be considered in future research.