FIX-MEDS: Finding Implementation Strategies to Improve Comprehensive Medication Review after Critical Illness
Modern hospital care makes it possible to survive once overwhelming critical illness. However, just because someone has survived enough to be discharged from the hospital, it does not mean they are healed. Complex, unique medication regimen changes, cognitive impairment, depression, anxiety, post-traumatic stress disorder, and physical functioning problems burden ICU survivors and their caregivers during the transition to home.
A few health systems are adding outpatient post-ICU or transition clinics to try to help these patients and their caregivers. However, diverse models are sprouting up. We propose to analyze the test case of how clinics engage the complex task of medication optimization in the post-discharge space. A pharmacist-provided comprehensive medication review in a post-ICU or transition clinic can address these medication problems.
The aim of this project is to examine why clinics take the various approaches that they do to incorporate comprehensive medication reviews and collaborative integrative care processes in post-ICU or transition clinics. To accomplish this aim, we will conduct interviews with interprofessional teams across an existing international collaborative of post-ICU Clinics. We will also observe patient flow through clinics of various types, how medications are optimized, and how shared clinical decision-making is done. The combined interview and observation results will be used to design a tailored, pilot implementation intervention to include pharmacists in the interprofessional post-ICU clinic team. This project will support additional training opportunities for health professions and PhD students, future grant submissions, and manuscripts.