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Meeting Patient Goals of Care
Louise Reader
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The second edition builds upon the previous content, exploring new and emerging evidence to enhance the structure and content of rehabilitation provided. It considers the additional impact of COVID-19 throughout each chapter. In addition, sadly not every patient survives their critical illness but good, multidisciplinary and holistic care is just as essential for these patients. The editors have added a chapter on end-of-life care, focusing on the importance of personalised care and family involvement and on PICS. Since 2020, healthcare professionals have faced unprecedented challenges caused by the COVID-19 pandemic. High levels of illness severity, along with stretched critical care capacity and workforces, meant rapid development of new patient pathways were required. This has deepened our understanding of the physical, psychological and cognitive impact of critical illness, as well as the need for services to deliver multi-professional, holistic programmes of rehabilitation to maximise outcomes.
An admission to ICU with a critical illness has a well-recognised physical, psychological and social impact all on the individual and their loved ones. Successful discharge from ICU requires significant attention to detail on all aspects of care concurrently to ensure a return to the best quality of life achievable. The new edition explores key areas to consider and ensure rehabilitation is delivered in a holistic way.
The chapters are written by a range of multidisciplinary ICU team members, providing expert guidance and an evidence-based approach to improve outcomes and return patients to their families.
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Carole Boulanger is a Consultant Advanced Critical Care Practitioner [ ACCP]/Nurse at the Royal Devon University NHS Foundation Trust. Carole was actively involved in the development of the ACCP role across the UK nationally as a workforce solution for ICU and represents ACCPs on the Faculty Board. Her primary focus is on high-quality educational provision across multi professional boundaries, person centred care, end of life care and effective communication. A past chair of ESICM Nursing & AHP committee Carole has ongoing active involvement in educational provision for ICU teams.
David McWilliams is a Professor of Critical Care and Rehabilitation / Clinical Academic Physiotherapist at University Hospitals Coventry and Warwickshire NHS Trust and Coventry University's Centre for Care Excellence. He is the chair of the physiotherapy working group for the European Society of Intensive Care Medicine, and deputy Chair for the Intensive Care Society National Rehabilitation Collaborative. David was a member of the guideline development group for the NICE guideline ‘Critical Illness rehabilitation’ and subsequent quality standard on the same topic. His research interests are focussed on rehabilitation and recovery following a period of critical illness. David is recognised as an international expert on critical care physiotherapy and rehabilitation, regularly presenting both nationally and internationally on the subject.
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