Khan Babar A, Lasiter Sue, Boustani Malaz A
Babar A. Khan is an assistant professor at the Indiana University School of Medicine in Indianapolis, where Malaz A. Boustani is a professor. Khan and Boustani are also affiliated with the Indiana University Center for Aging Research and with the Regenstrief Institute, Inc., also in Indianapolis. Sue Lasiter is an assistant professor at the Indiana University School of Nursing. The authors acknowledge Lisa Hovious for her role as a care coordinator at the Critical Care Recovery Center (CCRC). The CCRC project received funding from Wishard Health Services. Khan's work on the project was supported through a career development award from the National Institute on Aging (NIA K23-AG043476); Boustani's work was partially supported through a grant from the same institute (R01AG034205). Contact author: Sue Lasiter,
Am J Nurs. 2015 Mar;115(3):24-31; quiz 34, 46. doi: 10.1097/01.NAJ.0000461807.42226.3e.
Five million Americans require admission to ICUs annually owing to life-threatening illnesses. Recent medical advances have resulted in higher survival rates for critically ill patients, who often have significant cognitive, physical, and psychological sequelae, known as postintensive care syndrome (PICS). This growing population threatens to overwhelm the current U.S. health care system, which lacks established clinical models for managing their care. Novel innovative models are urgently needed. To this end, the pulmonary/critical care and geriatrics divisions at the Indiana University School of Medicine joined forces to develop and implement a collaborative care model, the Critical Care Recovery Center (CCRC). Its mission is to maximize the cognitive, physical, and psychological recovery of ICU survivors. Developed around the principles of implementation and complexity science, the CCRC opened in 2011 as a clinical center with a secondary research focus. Care is provided through a pre-CCRC patient and caregiver needs assessment, an initial diagnostic workup visit, and a follow-up visit that includes a family conference. With its sole focus on the prevention and treatment of PICS, the CCRC represents an innovative prototype aimed at modifying post-critical illness morbidities and improving the ICU survivor's quality of life.
每年有500万美国人因危及生命的疾病而需要入住重症监护病房。最近的医学进展使重症患者的存活率提高,但这些患者往往会出现严重的认知、身体和心理后遗症,即所谓的重症监护后综合征(PICS)。这一不断增长的人群可能会使目前缺乏成熟临床管理模式的美国医疗保健系统不堪重负。因此,迫切需要新颖的创新模式。为此,印第安纳大学医学院的肺病/重症监护科和老年病科联手开发并实施了一种协作护理模式,即重症监护康复中心(CCRC)。其使命是最大限度地促进重症监护病房幸存者的认知、身体和心理恢复。CCRC围绕实施原则和复杂性科学建立,于2011年作为一个临床中心开业,同时兼顾二级研究重点。通过CCRC前患者及护理人员需求评估、初次诊断检查就诊以及包括家庭会议在内的随访就诊来提供护理。CCRC仅专注于PICS的预防和治疗,是一个旨在改变危重症后发病情况并提高重症监护病房幸存者生活质量的创新原型。