title: Respiratory failure. After the intensive care unit.
abstract: RF is a unique situation. It is specific in diagnosis and yet, at the same time, broad in concept. It can be acutely life threatening or chronic in presentation and need for intervention. Patients are cared for in ICUs, medical-surgical floors, and nursing homes as well as at home. When RF is a complicating condition of an already hospitalized patient, the road to recovery may be long and complicated. It is important that the health care team provides education and counseling so that the patient and family can cope with the changing events and the potentially long road to recovery. Outcome data from all the sites of care are currently lacking for a comparative analysis of the most effective site. All the sites of care discussed in this article are cost-effective alternatives to the ICU, but there is a lack of standards and evidence of measurable outcomes such as the quality and cost relationship. Outcome data are needed to document the cost of care and the relationship of that cost to specific outcomes such as final discharge disposition, survival, complications, and quality of life. Health care provides have a much clearer image of the care that can be provided in the multiple sites available. Unfortunately, patients and families do not have that same level of understanding. For many patients and families, regardless of what the facility is called, it is not the acute hospital, and that is where they wish to remain until discharge home. Clarification and standardization are needed regarding the terminology used to describe the various sites of care. It is important that integrated health care institutions provide education and counseling to patients and families regarding the continuum of care and the many alternatives along that path.
authors.affiliation: Department of Patient Care Services, Sinai Hospital of Baltimore, Maryland, USA.
authors.forename: M
authors.initials: M
authors.lastname: McCord
mesh_terms: D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003422:Critical Care / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D010351:Patient Discharge; D011383:Progressive Patient Care / Q000458:organization & administration*; D012131:Respiratory Insufficiency / Q000150:complications / Q000451:nursing* / Q000534:rehabilitation*