Ohio State Researchers Launch NIH-Funded Study on Ozone-Induced Pulmonary Inflammation
Although survival after critical illness continues to improve nationwide, our health care system is struggling with a new public health problem, as more than 50% of critical illness survivors are burdened with long-term physical, cognitive or mental health impairments collectively referred to as post-intensive care syndrome or PICS.
“We know that PICS disproportionately affects those with socioeconomic barriers to health, and many of our own patients admitted to the Medical Intensive Care Unit at our University Hospital or East Hospital often lack adequate outpatient care,” says Kyle Stinehart, MD, MPH, a pulmonary and critical care medicine specialist at The Ohio State University Wexner Medical Center and clinical assistant professor of Internal Medicine in The Ohio State University College of Medicine.
“These persistent barriers to care and the lack of a trusted provider relationship not only elevate the chance of someone coming to the MICU in the first place, but they also make recovery following discharge particularly challenging.”
Focusing specifically on post-ICU care transitions, Dr. Stinehart has spearheaded a multidisciplinary effort at Ohio State known as the Critical Illness Transition and Recovery Program (CI-TRP). The initiative addresses two distinct clinical needs: immediate post-hospitalization care, and PICS screening and longitudinal care for all enrolled patients.
Using a dedicated nurse coordinator along with a team of critical care pharmacists, pulmonary and critical care physicians, outpatient social workers, physical and occupational therapists and cognitive and behavioral health specialists, CI-TRP ensures that a coordinated patient relationship is first established in the hospital.
“We want to reinforce our commitment to the patient and families before they ever leave our inpatient care,” Dr. Stinehart says. “While they’re still in the ICU, our nurse coordinator works with MICU clinicians, case managers and social workers to get patients enrolled. This is followed with a one-on-one visit to complete important screenings, share education materials and begin establishing connections with community resources. Before the patient is even discharged, they already have an appointment for a future clinic visit with our team. In addition to facilitating in-person clinic visits, we also designed the entire program to be telehealth-capable so we can meet the needs of patients in rural areas or those with mobility or transportation issues.”
The nurse coordinator then stays in close communication with patients and their families immediately after their hospital discharge to monitor symptoms and identify any difficulties adhering to prescribed treatments.
“This catches problems before they become more serious and allows us to make adjustments to the patient’s care plan. It also gives us an opportunity to connect individuals and their families to additional resources,” Dr. Stinehart says. “By the time the patient is in our clinic, we’re already aware of their challenges and can work with our multidisciplinary team to coordinate the best care possible.”
During monthly multidisciplinary care conferences, the CI-TRP team continues to discuss and refine treatment plans. Starting at enrollment and continuing throughout the entire process, the program closely collaborates with a patient’s new or already-established primary care provider to ensure continuity of care.
The CI-TRP was launched using a Patient Care Innovation Award, a funding mechanism developed by OSU Physicians, Inc. (OSUP), to give faculty members from the Ohio State College of Medicine an opportunity to pursue innovative ideas to increase access to our high-quality care for patients with Medicaid coverage. The award provides recipients up to $500,000 over a three-year period to pursue a passion project that meets patients where they are and eliminates barriers to treatment. OSUP is a multispecialty physician group that manages the Ohio State Wexner Medical Center’s outpatient physician clinics.
“Ohio State is a referral hospital that accepts critically ill patients from across the state,” Dr. Stinehart says. “Maintaining contact with our most vulnerable patients in those first days and months after they leave us can make all the difference in their recovery.”
If you’d like more information about the Critical Illness Transition and Recovery Program at Ohio State, contact Dr. Stinehart at kyle.stinehart@osumc.edu.
Learn more about innovations in care and research from the Division of Pulmonary, Critical Care and Sleep Medicine.
