Currently, there are a very few programs in United States serving this purpose.

There are very few centers attempting to address post-ICU syndrome utilizing multidisciplinary team. Each of these programs is different with resource utilization

Here is a current list of ICU survival clinics in the United States:

California Post-ICU Recovery Clinic University of California at San Diego San Diego, California Website: https://health.ucsd.edu/specialties/pulmonary/Pages/Recovery-from-Intensive-Care.aspx Referral call line: + 800 926-8273 Inquiries: + 855 355-5864 posticu@ucsd.edu

Colorado Critical Illness Recovery Center National Jewish Health Denver, Colorado Website: https://www.nationaljewish.org/treatment-programs/directory/critical-illness-recovery-center​​​​ Referral call line: Phone: + 877 225-5654 Fax: + 303 270-2153 Inquiries: Phone: + 303 398-1867 Fax: + 303 398-1452

Illinois Captain James A. Lovell Federal Health Care Center Chicago, Ilinois

Indiana Critical Care Recovery Center Eskenazi Health Indianapolis, Indiana Website: http://www.eskenazihealth.edu/health-services/recovery-center Referral call line: Phone: + 317 880-2224 Fax: + 317 880-0412

Kentucky ICU Recovery Clinic University of Kentucky Lexington, Kentucky Referral call line: + 859 323-9555

Massachusetts After the ICU Brigham and Women’s Hospital Boston, Massachusetts Website: www.aftertheicu.org Referral call line: + 617 732-6770

Michigan University of Michigan Post ICU Longitudinal Survivor Experience (PULSE) Clinic Referral call line: 734-647-9342 Ann Arbor, Michigan

Missouri Washington University School of Medicine St. Louis, Missouri

New York Mount Sinai Hospital Mount Sinai Critical Care Resilience Program (MSCCRP) New York City, NY Referral call line: 212-241-6039

North Carolina Critical Illness, Injury, and Recovery Research Center Wake Forest Baptist Health Winston-Salem, North Carolina Referral call line: + 336 716-4649

Ohio University Hospitals Cleveland Medical Center Cleveland, Ohio

Pennsylvania ICU Survivor Clinic Geisinger Medical Center Danville, Pennsylvania Referral call line: + 570 271-6211 (Geisinger Health Plan patients only)

Critical Illness Recovery Center UPMC Mercy Hospital Pittsburgh, PA Phone: 412-232-5992 Jefferson University Philadelphia, Pennsylvania

Tennessee ICU Recovery Center Vanderbilt University Medical Center Nashville, Tennessee Referral call line: + 615 322-2368

Utah Health Trauma Clinic Intermountain Medical Center Murray, Utah Referral call line: + 801 507-6437 Inquiries: ICU_ARC@imail.org

Virginia Centra Post ICU Clinic Lynchburg, Virginia Support group email: AftertheICU@gmail.com Appointments +1 434 200-3564 www.centrahealth.com/CriticalCare

International ICU survival clinics Hospital Italiano de Buenos Aires Buenos Aires, Argentina Kingston Health Sciences Centre Kingston, Ontario, Canada Montreal General Hospital Montreal, Québec, Canada Hospital Universitario de Fuenlabrada Madrid, Spain Guy's and St. Thomas’ NHS Foundation Trust London, United Kingdom St Bartholomew's Hospital London, United Kingdom www.bartshealth.nhs.uk/critical-care-follow-up NHS Greater Glasgow Glasgow, United Kingdom

The Society of critical care medicine has been leading initiatives to address this aspect of healthcare, the annual Congress has a dedicated sessions on discussion and raising awareness of this unique set of problems. Through the Thrive collaborative(SCCM's initiate), Different models are being utilised as examples to deliver care/address post-ICU syndrome

These programs are very unique in purpose.

The major needs include: Need for additional training to identify and address this unique set of problems, having a multidisciplinary team that can function effectively and economically at the same time

The next challenge is transitioning this care from an inpatient setting to the community setting, where the patient is challenged with real-life needs and a variety of minor problems including but not limited to coordinatiion of care between multiple disciplines, establishing seamless transition, ensuring adequate social support, and optimising resources necessary in the community setting

The high case-mix index, polypharmacy and limited physiologic reserves further complicate this process

The reason for this kind of service/program being so rare/scares/difficult to establish and maintain is because of the challenges in the current complicated system of medical practice

  1. Need for further training to address this high-risk patient population
  2. Need for multi-disciplinary input while patient is in hospital
  3. Challenges of establishing a seamless transition between inpatient care and outpatient followup
  4. Challenges in integrating a new program within already established busy programs especially when there is need for further training outside of the scope of physician team practice
  1. Provide training for young physicians and prepare them competent to establish and run successfully post-ICU translational care service
  2. Establish support groups that facilitate ICU survivors to share their experiences and enhance potential to fast and optimal recovery
  3. Incorporate nurse navigators in the post-ICU translational program
  4. Raise awareness in the primary care physician community on the prevalence of post-ICU syndrome and available resources to help affected individuals
  5. Design a system for Medicare/Medicaid patients/patients without insurance that simplifies healthcare delivery and affordable to all