Annie Johnson, ACNP, MSN, FCCM
Nurse Practitioner
Mayo Clinic
Rochester, Minnesota
Disclosure information not submitted.
Shannon Piche, PharmD
PharmD, RPh
Mayo Clinic, Minnesota, United States
Disclosure information not submitted.
Sarah Burke, LICSW
Social Worker
Mayo Clinic, Minnesota, United States
Disclosure information not submitted.
Richard Oeckler, MD, PhD
MD
Mayo Clinic, Minnesota, United States
Disclosure information not submitted.
Hannah Lechner, MHA
Healthcare Engineer
Mayo Clnic, Minnesota, United States
Disclosure information not submitted.
Lindsey Lehman
Disclosure information not submitted.
Title: Virtual is Reality: Impact & logistics of transitioning a post-ICU clinic from in person to virtual
Case Report Body
Introduction: The Mayo Clinic ICU Recovery Program (MCIRP) is a multidisciplinary clinic that focuses on connecting post-ICU patients to resources needed following hospital discharge to help patients achieve the most successful recovery possible. At its inception in 2019, this was a traditional in-person appointment with time blocked for each member of the care team to interact with the patient. A virtual aspect to this clinic was always in the plans, but the global COVID-19 pandemic accelerated this vision. In March 2020, all in-person clinic appointments were temporarily paused at Mayo Clinic due to the pandemic. To ensure that post-ICU patients continued to receive necessary care, the MCIRP was reinvented into a fully virtual appointment in just a matter of days.
Description: From September 2019 to February 2020, all MCIRP patients were seen in-person by a nurse practitioner, pharmacist, and occupational therapist. Each appointment lasted up to three hours and was held four times per month with six appointment openings per day. With in-person appointments paused, the MCIRP team focused on developing the virtual clinic with the option of teleconference or video visit. The visits were shortened to one hour in length, allowing for greater efficiency and clinic capacity with eight appointments each clinic day. Because of the federal emergency orders, there were no restrictions regarding state licensing when caring for patients virtually who resided outside of Minnesota allowing for an expanded clinic reach.
Discussion: Overall, the transition from in-person to virtual clinic appointments for the MCIRP has been successful. Patient accessibility to the clinic increased as reflected by appointment slots filled which, when comparing in-person to virtual clinic, was 45% and 72% respectively. In the first 6 months of in-person clinic 36 patients were seen as compared to 117 in the first 6 months of virtual clinic. The clinic’s geographical reach was significantly broader virtually as well with patients seen from 23 different states vs. 3 states in the in-person model. Other success indicators for the virtual clinic include ease of delivery and reproducibility with little to no infrastructure needed other than a telephone, sustained meaningful interventions, and high clinic staff satisfaction.