Long-Term Acute Care: Where Does It Fit in the Health Care Continuum?

As technological advancements have been introduced into the intensive care environment, the volume of patients surviving the acute illness or trauma phase has increased. Many of these patients become chronically critically ill. Chronic critical illness, a term first used in 1985, refers to the subset of patients requiring prolonged mechanical ventilation, those who experience multisystem organ failure, and those patients referred to as the “damaged survivors of critical care.”¹  In addition to their multiple organ system failures, these patients experience profound muscle weakness, debilitation and require periods of prolonged recovery. Recovery of the chronically critically ill has been described as slow; occurring over weeks or months.² 

Care of this population requires a skill set that blends critical care expertise with rehabilitation. The need for acute nursing and medical care extends significantly beyond the expected length of stay as seen in a traditional hospital environment. Extended acute care may...