Navigating a fragmented care system: a qualitative study exploring the combined perspectives of critical care survivors and their clinicians.

Recovery following a critical illness is challenging. Follow-up clinic provision is standard of care, but the effectiveness of services remain unclear, with some data demonstrating limited or potential detrimental effects. While the patients perspective has been described previously, no studies combine with clinician experience. We explored the experiences of patients and clinicians to understand modifiable factors in delivering effective post-critical care recovery services. A single-centre qualitative study was conducted as part of an evaluation of a new care navigator service. Semi-structured interviews were conducted with patients and clinicians, and themes identified. Sixteen patients and seven clinicians were interviewed. Emergent themes highlighted challenges in coordination between hospital, community and social care teams. Fragmented care was a significant barrier to recovery, resulting in frustration. Clinicians recognised the heterogenous nature of recovery and emphasised the need for patients to receive better support navigating the recovery process. Our data highlight the importance of integrated follow-up care for critical illness survivors and the need for clinicians to act as navigators within fragmented care systems. Systemic improvements in follow-up care are required, as is the integration of social and healthcare services to ensure that patients receive timely and comprehensive support.