What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

Due to complexities and longevity of post-ICU recovery, NICE guidance is that all critical care patients should be able to access Critical Care follow up services. This is because irrespective of length of stay or condition, all patients are at risk of Post Intensive Care Syndrome (PICS). However, due to restraints on resources, only a targeted proportion of patients (approximately 20%) receive any ‘follow up’. This selected cohort receive a telephone call post discharge and, if necessary, a virtual clinic.

This change proposal involves being able to deliver a virtual ‘Recovery School’ (RS) which could reach out to ALL critical care patients once home. Sessions would include pre-recorded podcasts by health professionals advising on ICU Recovery / PICS, time for peer support but also a live facilitator (senior nurse +/- physio) to answer questions, reassure, triage to clinic or signpost on if necessary e.g. to community services.

What does your project aim to achieve?

Fundamentally, following up all of our ICU patients will highlight any future clinical service needs, and reduce their delays in recognising and accessing these services.

Our Objectives:

• Set up all discharged General ICU patients onto the Trust Digital system (My Medical Record – MyMR) enabling them to have a direct link with the ICU follow up team.
• Invite patients to participate in the virtual Recovery School once discharged home, to alleviate fears, provide assurance regrading PICS symptoms, and triage those needing further support who otherwise would have not necessarily have been identified or followed up.
• Use the MyMR to automatically prompt recovery patients to complete online screening tools at key points on a timeline, to measure their level of recovery and ongoing need for support or intervention.
• Use the platform to create a digital library of local resources available, as well as for evaluation of the service.

How will the project be delivered?

Key staff, from multidisciplinary professions, would be approached to create podcasts, and advice and learning sought from the Trusts virtual ‘Surgery School’ practitioners and post-ICU rehabilitation leads.

Once the MyMR interface is created by the Trust Digital team, the senior nurse would optimise the current inpatient follow-up role to promote attendance. Patients not seen in hospital would be contacted once home with the link to their MyMR account and the Recovery School.

Anticipated that patients attend once to access all sessions and re-attendance can be accommodated (as no financial impact). Senior nurse to facilitate live sessions to mitigate risk.

Screening tools utilised at key points on a timeline and used to highlight where further team input is required, and evaluation forms used pre and post Recovery School.

Support to be provided for those with no / limited IT access potentially through ipads and dongles.

How is your project going to share learning?

Presentation on the Recovery School and its development / evolution / evaluation / will be shared at local level across the acute NHS Trust, with information on the Recovery School provided to the local primary care community for information or referral in.

Presentation on the Recovery School and its progress / evolution / feedback will also be shared through the regional critical care network (the network has representation from 20 Critical Care Units within Thames Valley & Wessex). We will also utilise national critical care contacts to share learning, as well as updating on progress widely through social media.

This learning could then be used by other organisations to help them evaluate if a similar service could be replicated within their Trusts.