Follow-up Protocol

We recommend discussing goals of care and prognosis with patients and families over no such discussion.

We suggest addressing goals of care early (within 72 hr) over late (72 hr or later).

There is insufficient evidence to make a recommendation on any specific standardized criterion to trigger goals of care discussion.

We recommend that the principles of palliative care (which may include palliative care consultation based on clinician judgement) be integrated into the treatment plan, when appropriate, to address patient and family symptoms and suffering.

We suggest against routine formal palliative care consultation for all patients over palliative care consultation based on clinician judgement.

We suggest referral to peer support groups over no such referral.

We suggest using a handoff process of critically important information at transitions of care over no such handoff process.

There is insufficient evidence to make a recommendation on the use of any specific structured handoff tool over usual handoff processes.

We recommend screening for economic and social support (including housing, nutritional, financial, and spiritual support), and make referrals where available to meet these needs.

We suggest offering written and verbal sepsis education (diagnosis, treatment, and post-ICU/post-sepsis syndrome) prior to hospital discharge and in the follow-up setting.

We recommend the clinical team provide the opportunity to participate in shared decision making in post-ICU and hospital discharge planning to ensure discharge plans are acceptable and feasible.

We suggest using a critical care transition program, compared with usual care, upon transfer to the floor.

We recommend reconciling medications at both ICU and hospital discharge.

We recommend including information about the ICU stay, sepsis and related diagnoses, treatments, and common impairments after sepsis in the written and verbal hospital discharge summary.

We recommend hospital discharge plans include follow-up with clinicians able to support and manage new and long-term sequelae.

There is insufficient evidence to make a recommendation on early post-hospital discharge follow-up compared with routine post-hospital discharge follow-up.

There is insufficient evidence to make a recommendation for or against early cognitive therapy.

We recommend assessment and follow-up for physical, cognitive, and emotional problems after hospital discharge.

We suggest referral to a post-critical illness follow-up program if available.

We suggest referral to a post-hospital rehabilitation program.