Understanding how post-intensive care follow-up is delivered within the role of critical care outreach teams: a qualitative study protocol.

introductionEach year over 130 000 patients in the UK are discharged from an intensive care unit (ICU), with many experiencing poor outcomes such as in-hospital mortality, emergency ICU readmission and/or significant morbidity. Despite current national guidance and the availability of follow-up services, post-ICU care remains variable. Critical Care Outreach Teams (CCOTs) are key in supporting this patient group, yet practice differs considerably. Recovery pathways have been successfully employed in other patient populations and are a potential option to standardise post-ICU care. Understanding how care is currently delivered by CCOT throughout the UK is essential to inform future development of an evidence-based recovery pathway for this patient group. Our primary aim is to understand how post-ICU follow-up care is delivered within the wider remit of CCOT workloads. METHODS AND ANALYSIS: This is a pragmatic multicentre qualitative study of post-ICU follow-up care. The study will be split into two sub-studies: semi-structured interviews and ethnographic observations. Semi-structured interviews will be conducted with three groups of individuals: multi-professional staff members involved in the care of patients discharged from ICU to the wards, patients discharged from ICU to the wards and their family members. Direct participant observations alongside ad hoc informal discussions will be undertaken with members of the CCOT at participating sites focusing on their workflow to generate an understanding of the CCOT role and how post-ICU support fits within this. An overarching thematic analysis approach will be taken to analyse data from both sub-studies to clearly identify the barriers and facilitators to providing post-ICU support within the CCOT role. ETHICS AND DISSEMINATION: Ethical approval has been obtained through the London-Chelsea Research Ethics Committee (25/PR/0773). We aim to disseminate the findings to local teams, at regional and international conferences, in peer-reviewed journals and through social media. TRIAL REGISTRATION NUMBER: ISRCTN14138257.