To improve standardized documentation of outcomes in a post-ICU NeuroRecovery clinic and use these data to identify patient-centric goals for recovery. 

Patients discharged after acute neurologic injuries require ongoing care for recovery and secondary neurologic complications. Most therapeutic trials for interventions geared to improve outcomes after acute neurologic injuries use measures of functionality as primary outcomes. Understanding patients’ perspectives can help providers tailor care and ultimately improve outcomes. 

The Post-ICU NeuroRecovery clinic at a tertiary care hospital identified two outcome measures as part of a Quality Improvement (QI) initiative: 1) Modified Rankin Scale (mRS), and 2) Free-text response to “What is the single most important thing the NeuroRecovery clinic can do to support you/your loved one in the journey of recovery”. A QI intervention consisting of weekly reminders to providers to use a SmartPhrase that integrated the outcome measures into clinical documentation was implemented. 

After the implementation of the QI intervention, documentation of the two outcomes improved from 33% to 63% for all clinic visits over a pilot period of 3 months (July-September 2022). Recurring themes abstracted from the free-text responses from 280 patients correlated with mRS categories as follows: mRS of 0-1 - assistance with cognition, sleep and return to work; mRS of 2 - improvement in functional/motor disability and driving; mRS 3-4 - assistance in recovery from persistent neurologic deficits, and information on novel treatments and interventions.  

We demonstrate the feasibility of standardized and systematic documentation of outcomes in a NeuroRecovery clinic, and the opportunity to identify and develop patient-centric goals for recovery.