Implementing a Post-ICU Clinic in a Large Medical Center: Methods, Barriers, and Lessons Learned

Introduction: Post-intensive care syndrome (PICS) refers to physical, cognitive, and psychological impairments that persist after ICU discharge. PICS poses long-term challenges for survivors and families, often resulting in disability and financial strain. Although awareness of PICS has grown, standardized mitigation strategies remain limited. PICS clinics offer a potential solution, but their implementation is sparse, and evidence of efficacy is still emerging. Here we outline the development and early implementation of a Critical Care Recovery Clinic (CCRC) at a tertiary care hospital in the southern U.S.


Methods: The CCRC was developed using a four-phase overlapping process: (1) defining intake criteria, (2) assessing feasibility and resource needs, (3) creating workflows and protocols, and (4) integrating with the hospital system. Eligible patients included ICU survivors with conditions such as prolonged mechanical ventilation, sepsis, or ARDS. Resource planning addressed staffing, funding, and space. Workflows were informed by literature review and a site visit to a model ICU recovery clinic. Integration efforts included IT system development, staff onboarding, and stakeholder engagement.


Results: The CCRC launched in November 2023 with a multidisciplinary team including intensivists, advanced practice providers, therapists, pharmacists, dietitians, social workers, and psychotherapists. The clinic supports ICU survivors in their transition to long-term recovery. Major challenges included funding limitations, IT delays, and coordination gaps between ICU and outpatient care. Patient adherence, care continuity, and sustainable funding remain key issues.


Conclusions: The lessons learned highlight the importance of phased implementation to reduce financial risk, early IT planning to minimize delays, and strong communication across care teams. Institutional support and stakeholder engagement are essential for long-term sustainability and growth. Ongoing outcome tracking will help optimize care models and justify future investment.
The CCRC has shown early promise in supporting ICU recovery, but significant barriers remain. Continued focus on integration, funding, and research is critical to improving PICS care.