Supporting patients and families after hospital discharge following critical illness: implementation and evaluation of a novel e-health resource NHS Lothian

Although the survival rate in UK intensive care units (ICUs) is over 70%, patients may experience significant physical and psychosocial problems after returning home. When they are discharged, patients and their families often receive poor information and guidance on the recovery process. GPs may not have the knowledge and referral strategies needed to help, and 40% of patients are re-admitted to hospital within six months.

To better support patients and families within ICU and following discharge, NHS Lothian has designed a novel e-health website that provides information, advice, strategies for self-management, and peer and professional support. It was designed in partnership with patients and families using the findings from over 100 qualitative patient interviews.

The project aimed to integrate the website into the post-ICU rehabilitation and follow-up service at the Royal Infirmary of Edinburgh. ICU nurses and a rehabilitation assistant introduced the initiative to patients and their families, and helped them to use it before discharge.

Evaluation through questionnaires and interviews with patients, family members and staff gave detailed insights into their experiences of using the website. Feedback was very positive and some patients reported experiencing improved, more person centred and better coordinated care. Constructive criticism was used to actively improve the website and facilitate its implementation into routine practice.

Staff engagement and collaborative working were key to the success of the project and have helped to ensure that the website is relevant, sensitive, safe and tailored to meet user needs.

Implementation was challenging, with many patients being too frail or unconfident to engage fully with the website. This was overcome by introducing it to motivated family members earlier in the patient’s journey and contacting discharged patients via telephone and letter to encourage them to use the website further on in their recovery. This innovation is now embedded in routine ICU care, providing patients and families with access to valuable information, advice and support throughout the recovery process.

This Innovating for Improvement project ran from the beginning of May 2015 until the end of July 2016.

Downloads

• Critical care recovery website
• Patients, family and ICU staff webcast
• A review of the website by Living It Up (a health, wellbeing and self-management website for the over 50s in Scotland)

Contact details

For more information about this project, please contact Dr Pam Ramsay or Professor Tim Walsh, Professor and Consultant in Critical Care, Edinburgh Royal Infirmary.