Doctoral Dissertation Research: A Syndrome of Care: The New Sciences of Survivorship at the Frontier of Medical Rescue

University Of Pennsylvania, Philadelphia PA

Investigators

Abstract

This doctoral dissertation research improvement grant supports a study that focuses on critical care medicine. Increasing numbers of Americans are experiencing care within Intensive Care Units (ICUs), which are hospital areas dedicated to the sickest patients and staffed by healthcare teams with advanced training in critical care medicine. Progress in the science and practice of critical care has improved survival among ICU patients. Yet some patients experience an extended period of ill-health after their ICU stay that is caused not only by illness but also by side-effects of interventions. For example, patients can suffer lasting muscle weakness from paralytic medicines used in sedation or symptoms of post-traumatic stress. These side-effects, which span physical, cognitive, and emotional domains of health, are collectively called Post-Intensive Care Syndrome. This syndrome can prevent former ICU patients from returning to their workplaces and family lives. However, it remains unclear how and by whom the medical and social ramifications of critical care can be addressed. This project will result in patient- and family-centered proposals for action to address and mitigate Post-Intensive Care Syndrome. The overarching goal of this project is to understand how medical professionals and health systems can address the consequences of intensive medical care among ICU survivors. How do healthcare workers in ICUs expand their goals and practices from short-term rescue to address the longer-term outcomes associated with Post-Intensive Care Syndrome? What new forms of longitudinal care for patients after the ICU need to be engineered? What does this syndrome reveal about the values, priorities, and challenges that underlie American health systems? While clinicians and patients alike hope for recovery, uncertainty remains about what recovery means and how it is experienced. In tracing how ICU survivorship is transformed through care practices, healthcare policy, and patient experience, this project contributes new understandings of recovery beyond medical rescue that will help to inform healthcare improvement. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.