TY - JOUR
T1 - Structured Multidisciplinary Follow-Up After Pediatric Intensive Care
T2 - A Model for Continuous Data-Driven Health Care Innovation
AU - de Sonnaville, Eleonore S. V.
AU - van Woensel, Job B. M.
AU - van Goudoever, Johannes B.
AU - Otten, Marieke H.
AU - Teela, Lorynn
AU - Aarnoudse-Moens, Cornelieke S. H.
AU - Terheggen-Lagro, Suzanne W. J.
AU - van der Hulst, Annelies E.
AU - Emma Children’s Hospital Amsterdam UMC Follow Me Program Consortium
AU - Engelen, Marc
AU - Kӧnigs, Marsh
AU - Oosterlaan, Jaap
AU - Knoester, Hennie
N1 - Funding Information: Supported, in part, by grants of the Janivo and C.J. Vaillant charity foundations. Also supported, in part, by the Emma’s Children Hospital, Amsterdam UMC. Funding Information: Dr. de Sonnaville’s institution received funding from Janivo and C.J. Vaillant. Dr. Konigs disclosed work for hire. The remaining authors have disclosed that they do not have any potential conflicts of interest. Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - OBJECTIVES: 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.
AB - OBJECTIVES: 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.
KW - child
KW - follow-up studies
KW - pediatric intensive care units
KW - postintensive care syndrome
UR - http://www.scopus.com/inward/record.url?scp=85160967995&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/PCC.0000000000003213
DO - https://doi.org/10.1097/PCC.0000000000003213
M3 - Article
C2 - 36807306
SN - 1529-7535
VL - 24
SP - 484
EP - 498
JO - Pediatric critical care medicine
JF - Pediatric critical care medicine
IS - 6
ER -