Table 1.

Possible contributors to inadequate diagnosis and treatment of PICS impairments in the outpatient setting

1) Lack of routine post-hospital follow-up with ICU physicians [2, 21].

2) ICU discharge planning and documentation often focuses on organ-specific issues and may not outline functional impairments that require follow-up [4].

3) Significant responsibility is placed on primary care physicians and outpatient physicians who are often unaware of the intensity of the traumatic and life-threatening experiences that ICU patients may have faced [4].

4) Generalised lack of awareness that PICS exists and is relatively common among ICU survivors [4].

5) ICU discharge planning and documentation often focuses on organ-specific issues and may not outline functional impairments that require follow-up [4].

6) PICS symptoms may be subtle and not readily apparent to the untrained clinician, and may have an onset many months following the acute hospitalisation.

7) No validated, universally used screening tools currently exist for assessing post-ICU patients for PICS [4].

8) No established rehabilitation pathway, as in stroke or traumatic brain injury. Rehabilitation clinicians may have less education on critical care issues that require intervention [4].

9) Lack of established best practice guidelines on how to best treat and support patient survivors [4].

10) Limited access to acute inpatient rehabilitation due to insurance constraints, which often require a minimum of 15 h of rehabilitation services per week and specific diagnosis codes [4].