Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review

Objectives:. To identify actionable processes of care, quality indicators, or performance measures and their evidence base relevant to patients with persistent or chronic critical illness and their family members including themes relating to patient/family experience. Data Sources:. Two authors inde...

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Autores principales:	Louise Rose, PhD, Laura Istanboulian, MN, Laura Allum, MSc, Lisa Burry, PharmD, Craig Dale, PhD, Nicholas Hart, PhD, Kalliopi Kydonaki, PhD, Pam Ramsay, PhD, Natalie Pattison, PhD, Bronwen Connolly, PhD, on behalf of the PatiEnt Reported Family Oriented perfoRmance Measures (PERFORM) Study Investigators, Andre Amaral, Shannon Carson, Christopher Cox, Brian H. Cuthbertson, Vagia Campbell, Eddy Fan, Jack Iwashyna, Vincent Lo, Lorrie Hamilton, Tracey Sharon, Deepak Varma
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2019
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/f7cac79d5f544a3394c692c03b424b96
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spelling	oai:doaj.org-article:f7cac79d5f544a3394c692c03b424b962021-11-25T07:49:58ZPatient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review2639-802810.1097/CCE.0000000000000005https://doaj.org/article/f7cac79d5f544a3394c692c03b424b962019-04-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000005https://doaj.org/toc/2639-8028Objectives:. To identify actionable processes of care, quality indicators, or performance measures and their evidence base relevant to patients with persistent or chronic critical illness and their family members including themes relating to patient/family experience. Data Sources:. Two authors independently searched electronic, systemic review, and trial registration databases (inception to November 2016). Study Selection:. We included studies with an ICU length of stay of greater than or equal to 7 days as an inclusion criterion and reported actionable processes of care; quality improvement indicators, measures, or tools; or patient/family experience. We excluded case series/reports of less than 10 patients. Data Extraction:. Paired authors independently extracted data and performed risk of bias assessment. Data Synthesis:. We screened 13,130 references identifying 114 primary studies and 102 relevant reviews. Primary studies reported data on 24,252 participants; median (interquartile range) sample size of 70 (32–182). We identified 42 distinct actionable processes of care, the most commonly investigated related to categories of 1) weaning methods (21 studies; 27 reviews); 2) rehabilitation, mobilization, and physiotherapy (20 studies; 40 reviews); and 3) provision of information, prognosis, and family communication (14 studies; 11 reviews). Processes with limited evidence were generally more patient-centered categories such as communication, promotion of sleep, symptom management, or family support. Of the 21 randomized controlled trials, only two were considered at low risk of bias across all six domains, whereas just two cohort studies and one qualitative study were considered of high quality. Conclusions:. We identified 42 distinct actionable processes of care relevant to patients with persistent or chronic critical illness and their families, with most frequently studied processes relating to weaning, rehabilitation/mobilization, and family communication. Qualitative studies highlighted the need to address psychologic needs and distressing symptoms as well as enabling patient communication. Our findings are informative for clinicians and decision-makers when planning high-quality patient and family-focused care.Louise Rose, PhDLaura Istanboulian, MNLaura Allum, MScLisa Burry, PharmDCraig Dale, PhDNicholas Hart, PhDKalliopi Kydonaki, PhDPam Ramsay, PhDNatalie Pattison, PhDBronwen Connolly, PhDon behalf of the PatiEnt Reported Family Oriented perfoRmance Measures (PERFORM) Study InvestigatorsAndre AmaralShannon CarsonChristopher CoxBrian H. CuthbertsonVagia CampbellEddy FanJack IwashynaVincent LoLorrie HamiltonTracey SharonDeepak VarmaWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 1, Iss 4, p e0005 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Louise Rose, PhD Laura Istanboulian, MN Laura Allum, MSc Lisa Burry, PharmD Craig Dale, PhD Nicholas Hart, PhD Kalliopi Kydonaki, PhD Pam Ramsay, PhD Natalie Pattison, PhD Bronwen Connolly, PhD on behalf of the PatiEnt Reported Family Oriented perfoRmance Measures (PERFORM) Study Investigators Andre Amaral Shannon Carson Christopher Cox Brian H. Cuthbertson Vagia Campbell Eddy Fan Jack Iwashyna Vincent Lo Lorrie Hamilton Tracey Sharon Deepak Varma Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review
description	Objectives:. To identify actionable processes of care, quality indicators, or performance measures and their evidence base relevant to patients with persistent or chronic critical illness and their family members including themes relating to patient/family experience. Data Sources:. Two authors independently searched electronic, systemic review, and trial registration databases (inception to November 2016). Study Selection:. We included studies with an ICU length of stay of greater than or equal to 7 days as an inclusion criterion and reported actionable processes of care; quality improvement indicators, measures, or tools; or patient/family experience. We excluded case series/reports of less than 10 patients. Data Extraction:. Paired authors independently extracted data and performed risk of bias assessment. Data Synthesis:. We screened 13,130 references identifying 114 primary studies and 102 relevant reviews. Primary studies reported data on 24,252 participants; median (interquartile range) sample size of 70 (32–182). We identified 42 distinct actionable processes of care, the most commonly investigated related to categories of 1) weaning methods (21 studies; 27 reviews); 2) rehabilitation, mobilization, and physiotherapy (20 studies; 40 reviews); and 3) provision of information, prognosis, and family communication (14 studies; 11 reviews). Processes with limited evidence were generally more patient-centered categories such as communication, promotion of sleep, symptom management, or family support. Of the 21 randomized controlled trials, only two were considered at low risk of bias across all six domains, whereas just two cohort studies and one qualitative study were considered of high quality. Conclusions:. We identified 42 distinct actionable processes of care relevant to patients with persistent or chronic critical illness and their families, with most frequently studied processes relating to weaning, rehabilitation/mobilization, and family communication. Qualitative studies highlighted the need to address psychologic needs and distressing symptoms as well as enabling patient communication. Our findings are informative for clinicians and decision-makers when planning high-quality patient and family-focused care.
format	article
author	Louise Rose, PhD Laura Istanboulian, MN Laura Allum, MSc Lisa Burry, PharmD Craig Dale, PhD Nicholas Hart, PhD Kalliopi Kydonaki, PhD Pam Ramsay, PhD Natalie Pattison, PhD Bronwen Connolly, PhD on behalf of the PatiEnt Reported Family Oriented perfoRmance Measures (PERFORM) Study Investigators Andre Amaral Shannon Carson Christopher Cox Brian H. Cuthbertson Vagia Campbell Eddy Fan Jack Iwashyna Vincent Lo Lorrie Hamilton Tracey Sharon Deepak Varma
author_facet	Louise Rose, PhD Laura Istanboulian, MN Laura Allum, MSc Lisa Burry, PharmD Craig Dale, PhD Nicholas Hart, PhD Kalliopi Kydonaki, PhD Pam Ramsay, PhD Natalie Pattison, PhD Bronwen Connolly, PhD on behalf of the PatiEnt Reported Family Oriented perfoRmance Measures (PERFORM) Study Investigators Andre Amaral Shannon Carson Christopher Cox Brian H. Cuthbertson Vagia Campbell Eddy Fan Jack Iwashyna Vincent Lo Lorrie Hamilton Tracey Sharon Deepak Varma
author_sort	Louise Rose, PhD
title	Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review
title_short	Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review
title_full	Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review
title_fullStr	Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review
title_full_unstemmed	Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review
title_sort	patient and family centered actionable processes of care and performance measures for persistent and chronic critical illness: a systematic review
publisher	Wolters Kluwer
publishDate	2019
url	https://doaj.org/article/f7cac79d5f544a3394c692c03b424b96
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Patient and Family Centered Actionable Processes of Care and Performance Measures for Persistent and Chronic Critical Illness: A Systematic Review

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