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In episode 132, David Richards shared with us the life-saving impact of his ICU diary. In this episode, Seth van der Meer from Post-ICU shares with us exciting technological advancements that can help make ICU diaries standardized and accessible for all patients.
Episode Transcription
Kali Dayton 0:47
Hello, I know we’ve had a month gap since the last episode. I’m here. We’re all alive and well, it has just been an exciting but overwhelming few months with intensive training of teams. Stay tuned for upcoming episodes with some of those incredible revolutionists that we’re working with that are doing amazing advancements with our teams.
This episode I’m excited to expound on the topic of ICU diaries. In episode 132. We heard from David Richards about the impact of his ICU diary on his journey through severe post ICU syndrome. This episode, Seth van der Meer joins us to share his exciting advancements that can help open access to ICU diaries for more patients, while limiting the workload required for clinicians. Thank you so much for coming on the podcast. Can you introduce yourself to our listeners?
Seth van der Meer 1:39
Yeah, sure. So my name is Jeff VanderMeer. I’m I live in the Netherlands, which most people probably know from Amsterdam. But I don’t live in Amsterdam. I live in a smaller town, close to the German border called nightmare. I have a wife three kids. And yeah, in my in my daily job, I’m running post ICU.
Kali Dayton 2:00
But I am fascinated with this whole concept and company. How did you even get into working on post-ICU diaries?
Seth van der Meer 2:09
Yeah, well, I didn’t know I would go in there. When we started. It was 2019. We were developing all kinds of applications for healthcare. I was involved with setting up patient programs, patient support programs for diabetes patients, rabbits. And I met two guys school to urea and Bariatric and Mark Bowden. And the latter one is a intensive install.
He was an intensivist, at the Catherine hospital. in Andover, he is now an intensivist anesthesiologist in Maastricht University. And so they were working on this idea of making an app for a diary. And I didn’t have any clue at that moment. But it became quickly very clear to me what the what the proposition was a simple proposition of having a notebook on your, on your phone, to record the everyday things that happen on a on an ICU.
And that that is important for the patient when he wakes up, but also for the family and for nurses. So, so I said, Yeah, I want to join. And at that time, there were it was it was, you know, it was just when COVID started. And that gave the whole project a booth boost. We, we quickly needed to roll it out in a lot of hospitals in the Netherlands.
And that also then sort of became the start of the company. It was it was first a project and it became a company because of the fact that we were dedicating so much time on it that we needed to separate it from the other things that we were doing. And that’s how it started. So
Kali Dayton 3:56
Interesting. And we’ve had David on the podcast talking about his journey through ARDS, and ECMO and this was in the early 2000s. So without the kind of technology and even they didn’t have clear instructions on this, it was just his partner at the time, was kind of a scrapbooker and had intuition. She just knew that this was going to be a very impactful event and David’s life and so she started to document it. So he talked about what that meant to him. But in the bigger picture. Why are ICU diaries needed?
Seth van der Meer 4:34
Yeah, so the whole idea of the ICU diary started around 2025 years ago in a more formal way where hospitals in Scandinavia started to block these events because they somehow had the idea that it could be beneficial to patients, because they know of course about the den not known Post intensive care syndrome, it was still called something else like anxiety, depression.
But they had this feeling like, well, this memory loss or this memory gap, and the problems that people have when they’re when they’re, you know, understanding things, sort of dementia kind of problems, that they are probably caused by something that we now call post intensive care syndrome. So they started to just write down, mainly nurses write down, not the medical events.
But the other things that happened with an around the patient. Things like who visited, what was going on during their day, what they you know, what they observed on the patient, like they had their eyes open or not. So, with that idea, they started to experiment. And everyone did it in his own way, right. So everyone had like, you know, this, like scramble kind of mentality, or a notebook kind of mentality and just write things down. Without any clear idea of what what was important. They just did they think was right.
And it took, I think, around a year 10 to 15 years before someone sort of started to look into well, are there actual benefits? I think this is this is only like in the last five to 10 years that people have really started to, from from, from a research perspective, have started to look into it, and started to look at are there benefits and a lot of people have the idea that there are benefits.
People know, from their gut, that journaling is something that can help to alleviate emotional stress for the writer, that reading back what happened to you could give you maybe some perspective on what happened to you. And then that narrative can help you get to grips with the things that you were not able to experience or at all, or maybe not in the right way. So I think with that around, around, I think 2010 It started really to become something that, you know, got more attention also from from a research perspective.
And that was still far away from where we are today. But at least the first studies that we found were from that time. So I think that that that’s when the first results came in that people were thinking we needed, we need to find a way to, to introduce this as a part of the care for the patient.
Kali Dayton 7:38
And I think back to my time in the wake and walking ICU that I worked at, I started there in 2012. And it was probably right before COVID head that we started to really try to roll out post ICU diaries. And even though we had this really great approach to be aware of delirium, prevent, treat it, things like that. I don’t think I as a nurse was really trained to focus on their post ICU life. Despite our optimal approach in there, I did not understand why we’re taking that approach.
So something like a post ICU diary had not crossed my mind. And not crossed, like really reached us there and Utah, in the United States of America, and tell right before COVID hit when I started. Watch, it was probably Bailey, the very founder of this unit really started to push for this, and I use it with a few patients before they just got crazy, and it fell by the wayside. So I think we haven’t been aware as far as I as clinicians in the ICU world. We’re not aware of what life is like after the ICU.
So we have not understood why tool like this would be so important or what patients experienced during the ICU. And what lies ahead for them. What other gaps have stopped this from being standardized?
Seth van der Meer 8:58
Yeah, so I think the the fact that it only was sort of like discovered 10 to 15 years ago, when researchers first started to look into the possible benefits that they started also to think about, well, if we are going to write for the patient. What would be beneficial to them? Should we just write anything?
Because one of the things that, you know, still happens today when hospitals are working with paper diaries, most of the times they’re just, you know, they’re just little scrapbooks or their little notebooks I heard from from nurses that just went to Office Depot to get some stuff and making themselves so it was there’s nothing standardized to them.
And I think there’s there’s a couple of things to that sort of, up until now at least stopped that from being standardized. First of all, they were not being met. Part of the the ICU liberation bundle. That’s only for a couple of years now that in the ICU liberation bundle, there’s at least a reference to a diary, there’s still no clear guidance on what to do and how to do it. And whether you would do it on paper or not.
But at least, it’s mentioned. And there’s other countries in the Netherlands but also in in Sweden, where we work, where this is now an official guideline from the intensivist Association, that they clearly advise you to start using a ICU diary as soon as possible after admission. So this will help right, the fact that it’s being pushed from the intensivist.
And also, because more nurse more and more nurses are. And there’s researchers and nursing schools are looking into this and trying to get some guidelines on how to write in an ICU diary or why to write an ICU diary. I think it starts with an why that’s also you know, we don’t know why we do it, it’s hard to make a standard because you don’t know what you’re solving.
And you’re not you don’t know, anything on on which steps to take. So that’s also a barrier where it’s still not clear to a lot of people. And not even what post intensive care syndrome is, but also not why something that sounds so simple. And so, almost. Yeah, I mean, it’s trivial, that that writing in a diary would help someone to recover. And this is, I think, these things are now coming together.
Right? It’s there’s, there’s the physical care, there’s the pharma care, but then there’s also the emotional or the mental care. And then that part can be can be really influenced by and positively influenced by having a an ICU diary. And, and, and getting a narrative around what happened to the patient? Or what happened to the family? Because the family are mostly the most, right the most.
So I think that’s where it only now comes, you know, to okay, if we’re going to do this, how are we going to do this? Do we need a standard and to give you one example, we we went to Sweden, where they were writing in a diary for over 15 years already in ICU with our post ICU application. And once we, we knocked on the door of the legal department, somebody woke up and said, Hey, are we doing paper diaries?
How is that arranged? How is consent arranged? How is privacy arranged? Is there any regulation and they found out they haven’t, you know, haven’t had any regulation around it? So that stopped us, you know, a couple of months because they needed to do to make that regulation. And then they found out I
Kali Dayton 12:54
hadn’t thought about that part of it.
Seth van der Meer 12:56
Yeah.
Kali Dayton 12:58
What if it contradicts the EMR? How does that play out? Is that something that could be used in court or?
Seth van der Meer 13:07
Yeah, very, that’s, that’s, you know, well, this goes back to that standardization, a little bit, because if you if you if you have no standards and methodology and nurses in family members just write in a paper book, nobody knows what’s being written, nobody has any control of who will read it.
Nobody knows where it ends up. So one of the things that we tried to do with our post ICU diary is that we make it clear that it is the property of the patient that it’s being most of the times being governed by the patient’s family, because the patient is not able to, to represent himself.
Kali Dayton 13:46
That depends on the ICU. It depends on the ICU, many patients, can be with it the entire time. But that is a fair concern. It
Seth van der Meer 13:57
depends a bit on how they end up in the ICU, right, whether it’s planned or unplanned. So but but we generally see it and most of the times there’s like a representative, a legal representative, mostly the spouse or the kids, that that sort of daycare of the diary until the patient is able to do so.
But then where’s the patient that a representative, they are the ones that invite the nurses or the hospital to write in their diary, they can set the rules for whether people are able to write to read whether to post pictures or not.
And then with that there’s a control mechanism there’s a system to to take care of their privacy and to make sure that the privacy is respected so that all these little things have helped us in getting on a better level with especially legal and privacy departments for arranging things like this, and so setting a standard on how to Do things.
Kali Dayton 15:00
And I think throughout our process of care in the ICU, we like to have routine structured and data driven. Processes, right. So we like to know what information to put where? Yeah. And so something like this where it’s not, at least thus far, it hasn’t been so objective. It’s been right about the patient’s course. Well, I found when I was rolling this out, I was wondering, do I what matters to the patient?
What would they want to know? So I took care of a paramedic and I thought, they’re gonna want to know what drips they were on weapons later said, instead, we’re on I’m gonna guess that they want to know those details. But I don’t think that’s going to be helpful for all survivors, because survivors have tried to go through their charts.
I’ve been contacted by survivors that say, “Can you read through my medical records? And give me a summary of what happened to me? Because I don’t know. Especially with my brain injury. Now, I can’t process the 1000s of pages.” So how have you or has post ICU? Have the company? Yeah, helped fill in this gap and streamline this process? Yeah.
Speaker 1 16:05
So yeah, that’s a good question. I literally, first of all, just to make that clear, the ICU diary, the way that we train the nurses, and we advise the family is not to write about medical information. So don’t put any medical information in there. There’s a medical record that contains you know, what you need to know, from a medical COVID, but it didn’t really write only about things that are not medical, just observations, experiences. And so with that, we also keep it really separated from the EMR. There’s no connection between the EMR and a diary. The only thing that stored sometimes in the EMR, but that depends on the hospital is like the consent form. So there’s a place where you leave that, that consent, so you know, that you’re allowed to write in the diary. But for the rest of there’s no connection. But what does happen, and this is what we hear back from us from a lot of hospitals, is that because your writing and diary data has timestamps, you can correlate that to the medical record. So what happens now also in research perspective, but also just by, by, by nurses and families and patients, that they can correlate what was happening to them in a more emotional or even sort of like memory, things that they have to what happens medically to them. So were they deeply sedated? And that they have certain like, nightmares or dreams or visions? Were they born in delirium face? And did they do they see things on the medical record that that correlate with what happened around them or with them, in the eyes of the family or the nurses, and that gives them so much more context to what happened to them, not just a medical thing, not just the story, but the combination of the two, especially,
Kali Dayton 18:02
I guess, involves their family members. It’s almost like the family members who said, “I wasn’t the perpetrator, that harm I was here I was reading your diary is at this time, but at that time, you also had a thoracentesis.”
Seth van der Meer 18:18
If you’re looking at the continuum of care for the patient, mostly, I mean, hopefully they have family whenever they have family or loved ones. Those are the ones that are with them all the time from before they were sick to the ICU and a long, long time after the ICU, right. So they are the ones that that are with you all the time.
And so what we are what we what we do see sometimes is that because of the traumatic experiences, let’s say spouses have different emotions, about their time and have difficulty sometimes in the relationship because of the traumatic things that happen to them. And so, again, the diary can play a role in at least having a joint narrative or have the proof almost to the patient that their loved ones were with them and not against them, because that’s what some delirious patients sometimes think.
And the same goes for, for nurses, because also nurses. Especially the aftercare, nurses, they they often when they get patients back with an ICU diary, that’s when they get the the thank yous right. So it was a horrible time. But now I read with you what you’ve done from you. What did you were there for me here that you’re rolling my hand where you were, you know, we’re changing my clothes or washing my hair, whatever they did with with divisions. And that’s a very emotional, very important moment for both the patient as well as the nurse.
Kali Dayton 19:46
Yes, because there could be a lot of really hard feelings. I mean, even if a patient understands that they had delirium, with without that clarity of what those providers were doing for them. It sounds like sometimes they still wonder, “Was that a bad nurse? Did that nurse really do that? Or was they were they doing something harmful that led me to believe that this was a dangerous situation?” So having that clarity, yeah would really help. And help me understand this is this is an app. Correct?
Seth van der Meer 21:20
It is rolled out. So it’s so but we kept it very simple. So it’s a web app. So it works on a phone on a tablet on a bedside terminal, basically on anything with a web browser, you could just go there log in, and you can write so it’s it’s a very simple app. And it’s not a notebook. Because we’ve seen with notebooks that people you know, they stare at a blank screen, and they have no clue what to write.
So it has an onboarding, it helps, especially on the on the on the family and patient side, it helps them through some conversational routines that you go through to explain them, what it is why they would be why writing is so important. If they want to learn more about post intensive care syndrome, they can read about it. And then it starts with a question, what do you want to write today? And the first and the first question then is, do you know what to write about? And if you say no, you’ll get prompts.
And those prompts, of course, are are prefilled. By the experience we have and the research that has shown what are important things to write about. Color sounds, what the room looks like, the temperature doesn’t even matter what so much, but physical things around the patient can be very important for their, for their memory. Or write about your their favorite sports team, whether they have won last weekend or not. It sounds a little bit strange to because they didn’t look it up in the paper or whatever, wherever.
But there’s one patient that unfortunately, I only have a Dutch way that he has a testimonial where he talks about that his friends. He was a big supporter of a football club here in the Netherlands. And he wasn’t COVID You know, at a COVID icu admission for six weeks. He was away for a long time and, and his team had at least six matches. And so he always went to the football game with his friends. So every day at matchday his friends were writing in his diary, just like the score who scored not because it was information that he needed, but it was their way of showing to the patient that they that he was still in their minds that he was there with them.
And I think that sense of I was not alone. The world continued without me, but not not completely because the people who cared for me, had me in their thoughts and they were writing for me they were doing as if I was there and think that aspect. It’s such a strong emotional thing. Even though it’s such a simple thing to just write the score, or who scored or in what manner they scored on a football match.
Kali Dayton 24:02
Yeah, patients that are especially deeply sedated seem to be at high risk of heart feeling isolated, and abandoned. And a lack of connection. I just think besides solitary confinement, from torture or imprisonment, what else do we go six weeks without really talking to her connecting to another human being? So I hadn’t considered that showing that connection and that support even retrospectively could be part of their healing.
Seth van der Meer 24:32
Yeah, So this is what we hear back. We I don’t know. I know it’s a there are a few rehab clinics now in the US that specifically work with ICU rehab as you recovery. In the Netherlands. It’s now standard in each hospital. There’s an aftercare department. Usually these are ICU nurses who double shift almost as after current care nurse. They invite the patient’s back at a regular interview intervals to, to talk to them and to their family.
So, so and this is where we learn all these things because they come back. They talk about their experience, they talk about what’s what’s in the diary, what it meant to them. And that’s where we hear those stories. So stories, they get told to us by the nurses, but also by the patients. So patients reach out to us through our just around our desk, right? We’re not soliciting for them, but we have a helpdesk. And if you’re sending us like all the stories about what it meant to them.
Kali Dayton 25:33
These stories, of your your successful rollout is the perspective of the nurses, being able to understand the post ICU life absolutely has to impact ICU care. So when they understand what patients face after the ICU, they’re better equipped to prepare them for that life. That’s a big gap, at least here in the United States is that I personally, I worked as an ICU nurse for almost seven years before I ever really talked to an ICU survivor that had been sedated and had delirium.
And I remember being an I still get upset to think I cared for these patients for so long without knowing what lies ahead. And I contributed to a lot of that struggle that they face, because I didn’t know now. So what kind of success stories are they shared? Do you have them examples? We love a good story.
Seth van der Meer 26:24
Yeah, so you know, let’s just start with the fact that, you know, she was never considered a success by recovering from ICU, of course, can be the enemy of success. So from the patient side, one of the stories that we did a lot is about, you know, his his name is Hans, but he, he was he was also alive, he was also in the covid.com. So he was he was sedated for a long time, intubated for a long time. And he is he was in his late 60s, early 70s. So really fragile patient at that time.
And he really thinks his recovery. For a large box to the diary. They, he says we keep so what he did, and that’s an ability that we have printed a diary, he even made it into into a nice booklet, which we’re also now offering that he brought us to the idea that you could print it into a book, including the pictures. And so he has it in an he just keeps it in a top drawer in his living room. And he now it’s three years gone. And he says they look at it almost every week, there are stairs, something comes up. And they take out the paper diary in the printed diary.
And it’s I think it’s a 30 page, diary, 35 page, and they just look at pictures, they look at things that happen because he says this helped me. And there are so many little things that happen in my life, things that I hear sounds that I cannot I don’t know what what they are, I get a fear of certain sounds, or I have a dream or there’s something that happened. He looks in his diary. So he’s really very, very happy. And he keeps on telling us and asking us, you know, how can I help you to spread that story.
So that’s, that’s really from, from a patient perspective, one of the most successful stories is really, really thankful that he had this handy, there’s opportunity, and so has his wife, right, because it was his wife that you know, was the one with, with family members and nurses enrolled in it. But he said it was a it really made his recovery, a much better recovery, then. And then maybe without it, you never really measure it against, you know, the not having it. But this is what we hear a lot from patients or from patients that sometimes it’s not a habit and said I would I would love to have it.
Kali Dayton 28:57
And that’s how user friendly it is to because then I think of some an app. You know, now even our older people are getting much more literate with with technology. That could be a barrier. I’m thinking of some of our veterans hospitals would this work for all demographics of society? Maybe not but to have someone in their 60s and that’s not my mind, it’s not that old, but it’s so user friendly even when they’re in a stressful traumatic situation that they can use this kind of technology easily.
Seth van der Meer 29:35
Well, you see, even even then, maybe we should not even talk about all are young but you know there are people that are you know, more used to technology and people that have more of an aversion against technology. And so, so but what we do see is that almost everyone has a mobile phone nowadays and they are able to text the most people are able to take And so this is why we made the application so much like a texting application until there’s there’s not a lot of buttons.
It’s really just as if you’re talking to your loved one or talking to the application, just by a simple conversational, you could say trick that we, that we, that we included to make it very natural to talk or to write. And I think that’s that, that there was a, there was a research done in Europe, with our application. Actually, the the results came out a couple of weeks ago, that specifically looked at the technological barriers for families and for nurses. And it found that there were hardly any sort of the mean age for that group was around 55.
So that means there were some older and some of the other people in there, and there were no real technical hurdles. For most people, the most, and most of the times the technical hurdles aren’t on the on the hospital or nursing side, not so much, because they don’t, they don’t know how to do it. But sometimes some nurses see it as yet another administrative task. So this is part of our education, or of our mission, also, to talk to nurses and to learn nurses that this is not an administrative task is really part of the care.
This is twice in the ABCDEF bundle. This is why it’s recommended by intensivist, the nurses as part of the care as part of family engagement, and not so much as an administrative task, but this is sometimes a hurdle that we still face that people see it as well, you know, so many, there’s so many things that we already have to do in a day, you know, now we also have to write.
Kali Dayton 31:42
Yeah, I mean, the states, at least, there’s just so much documentation and some of some of its repetitive and I think already are clinicians are spending too much time on the computer versus with patients. So I could see that being a struggle, especially as you’re starting off, and it might take longer, because you don’t know what to write, you’re getting used to it. Anything that’s new, seems to take more time initially.
Seth van der Meer 32:05
Yeah, so So there’s one thing that that we usually so there’s that it’s also it’s tricky, that we some steps that we sometimes deal with, with, with with hospitals, a lot of hospitals that we engage with, with our application, they, they provide iPads to right on, some of them do it on the bedside terminals. But there are a lot that say, “Well, we have specific iPads for them, because then the nurses can also take a picture with an iPad and included in the diary.”
So one last thing, and this is what we’ve learned from nurses, nurses that if you put Netflix on the same, I bet it will always be charged. And then we will always be confronted with the the application as well. And this is because they were telling us well, in the in the night shifts, there’s enough time to write, yes, it can be busy at sometimes, and you can never really predict how it’s going. But usually there’s more time during the night.
So early mornings, an hour before the shift stops, and you wouldn’t be a great time to write. And also if you write in the morning, like six, seven o’clock in the morning, you know, family members will open up the app, and will read about their loved one and will not call the ICU. So this will save them some time as well. So this is how we work. And this is what we do together with nurses, this is not what we are telling they have to do.
But in the way that we are designing this we are including the practice of nursing, and try to adapt it as much as possible to their way of working otherwise, you know, it’s like I said, it just another thing they need to do. And now it sort of becomes something that they that they that they like to do and that they feel as natural to do because it’s part of their care and also much part of the administration.
Kali Dayton 33:49
Yeah, throughout the consulting, I’ve learned a lot of things about systems and processes. And absolutely every ICU is different. They have their own culture, their own processes. You know, some ICUs are gonna have more surgeries, procedures, patients leave, you’ve got to build in this kind of intervention and to that individual ICU, and you’ve got to have nursing buy in, and nurses need to be part of figuring out what works for the team. So having someone from above or the sides, barking out orders, can provide ideas and share what’s worked for other ICUs. But this is something that the team as a whole needs to decide to do, and figure out how to do it and streamline the process.
Seth van der Meer 34:30
Yes, absolutely. I think that’s that’s where that’s, that’s crucial. And yeah, like you said, if you’re if you’re implementing something in an ICU, you really have to make sure it becomes something that belongs to how they operate and not so much a foreign you know, application or procedure that they are that they don’t feel as naturally fitting with what their what their their job is. So that’s true and but on the other hand, they If I then look at what are your 25, 30 ICUs, that we have it implemented?
Generally, they’re a lot the same. I mean, they’re saying the same things happen. And yes, culture is different. But But in essence, they work closely with the same EMR to the same procedure in the same machines, and the same sort of people. So there is there is sort of a Heisei standard that we’re that I think is becoming to, to grow. And hopefully we can roll that standard out into into more hospitals, not so much just the application, but just a practice of writing.
And up until now, I don’t know if there are a lot, I don’t think there are a lot of other digital diaries. But even if there are I would, I would recommend every ICU to start looking at it. Because it’s a great way to document that period. And it really helps patients and it really helps families, I think that’s something that’s still under researched. But the effect it has on prevention of post intensive care family is really important as well. And the writing the the benefits of journaling, writing your emotions into text, channeling that into something that you know, is on paper, and they can reflect upon is something that that also can help a lot in Yeah, in prevention of problems, traumatic stress syndrome stat that occur in families.
Kali Dayton 36:33
I had a wife whose husband was intubated, and he was awake and walking for the first few days. And then he got to the point where he couldn’t oxygenate with movement required, pronation and paralysis, deep sedation, so and even when he was awake prior to that he was delirious. So she was not able to really connect with him during such a stressful time. And he was in his early 30s, and had three little kids.
And so she usually during stressful traumatic situations, couldn’t lean on him. But he was unavailable. But she yearned to connect with him. So writing in the diary, she said it was like I was able to communicate with him. Yes. And I think about I mean, I text my husband more than I write letters to him. So maybe it would be a quicker, more organic way to talk to him as my husband in that situation, it felt it would feel like you’re actually having a conversation, even if you’re, you’re not and you’re right into their future selves.
So you’re you’re planning you’re doing some intervention to prepare them, to help them and also just planning on the future, like the optimism that must bring to put things into perspective of here we are now that I’m talking to you, the future you because yeah, I’m hoping that there is going to be a future you I’m planning on it.
Seth van der Meer 37:49
Absolutely. I think that so that’s that’s a that’s a great example where the connection will happen at a later stage. But you’re doing it out here. And I think this is something there’s another terminology for it. We sort of invented it, or at least we gave it a name social journaling. Basically, you’re journaling for someone else. And that’s a unique thing, right? You’re not just writing for yourself, but you’re writing for or to someone else.
Kali Dayton 38:20
Yeah, yeah. Yeah. Yeah, I like that. Yeah. I just throughout my journey of podcasting, and consulting, I’ve been gathering up different tools, things to streamline these kinds of processes. And so I’m, I’m automatically just talking out loud, right? I’m thinking of things that fit into an iPad. Most of our ICUs got iPads during COVID, for zooming. And most of those iPads are collecting dust on the shelf now.
And we use iPads for translate of services. But a lot of times, it’s just a specific iPad, maybe there are two iPads. And when I see you and they’re just so in my dream ICU, each room would have an iPad, which is actually already accessible in many ICUs. There’s your app, there’s which can be on the iPad and or on patients phones, right. But there’s also apps like Vita talk that have communication, not from nonverbal communication in 40 different languages.
There are cognitive apps, like Sudoku puzzles and things that keep their cognition going. And part of occupational and speech therapy. You mentioned Netflix entertainment, like you can if we were to really combine all these tools into one because it feels like a lot to roll it out. But if we kept these things easily accessible and standardized on each iPad for each room, it could I think that is where we need to be moving towards for the future when we already have it’s 2024 We have so much technology. But everyone has different levels of progress when it comes to how up to date they are.
Seth van der Meer 39:57
Absolutely. So yeah, I think of you She’ll walk into most analogies types use, but any any hospital rooms, now you see phones chargers, you see tablets, you saw all kinds of devices, from the patient from the family. But and so I think if you would provide something like you just described, and I know there are a few hospitals that aren’t doing something like this, that it is knowing, then you can, we don’t want to control but at least you have an influence on things that are on that iPad that you know, will be beneficial to the current or future patient, right.
That can be journaling, it can be the, the cognition gains, or it can be, you know, these kinds of things where you have them there, and they’re available. And you know, that they are a part of, of the healing or part of the care. And I think that’s, that would be, you know, the future hospital or I would even say the hospital of today would need something like that. And it would be great if there were more of those initiatives. I know, there are a few. I was actually visiting one Tuesday in Belgium, where they build a complete new hospital in Antwerp.
That is aiming to be the future hospital. So I am going to find out. And I think I think there are more of those hospitals, but it’s still like fragmented. And there’s not a lot of visionaries behind that that are that are that are pushing this, I think and that would be that would be great. But on the other hand, there are so many digital struggles that hospitals are still going through today. They might be a bit scared to, to go to this to go on these routes.
Kali Dayton 41:42
But there’s so much potential there. It’s like you all these companies, that’s it get together have a Paulo have a complete bundle. I’m just I just been trying to make contact with everyone and really make this information accessible to dicey community throughout the world as a whole. How can they get a hold of you?
Seth van der Meer 42:00
Well, of course they can. They can Google post ICU diary, right, or they could just go to post ico.com. We try to be out there. We try to share as much as possible information and research and but it can always be more so but if they’re looking specifically for Ross, they could always look at post dash icu.com. And they would find us. But I would also advise people just to do Google and post ICU die research. There’s lots of information, there’s more and more information coming out of post ICU and Oracle so is a great website that has information from researchers, survivors and family members.
So those are a couple of interesting websites to go to. There’s also an ICU diary.org, I think from from a researcher in in Germany, Peter Nieto. He’s also doing a lot of studies also on diaries, but also on both sides and post intensive care system. So that information is now slowly growing. And I would have I mean, I know you had him in the podcast also. But I would also recommend to read Wes Ely’s book, “Every Deep Drawn Breath”, where he describes the diary.
And he describes also the benefits of making the connection to the patient and the family, which is part of the diary. Right? It’s the family engagement part. And you know, that also was so inspiring to read even though we were already busy with the diary. So that’s also why we connected with him. And we are we are setting up a feasibility study with Vanderbilt and Marquette University this year to try to find out what what are the barriers to entry in US hospitals.
And, of course, to set the standard hopefully, or at least a standard for hospitals to start adapting and adopting it in the US. We only have one hospital now. It’s in Derby. It’s called Griffin house in Connecticut to derby. But we’re aiming together with Vanderbilt and Marquette to further the standardization actually by doing a feasibility study.
Kali Dayton 44:09
Right. So looking for US hospitals to be participants in the study?
Seth van der Meer 44:15
Absolutely, Yeah. So that would be great. We were looking for populations where we could do the the the research, especially around the Milwaukee area, because Marquette doesn’t have their own university hospital. So that would be really interesting. If there would be hospitals interested then they could turn to contact so of course, hey,
Kali Dayton 44:33
listeners, raise your hands. Jump in. Yeah, I mean, it’s like basically a free trial. Right?
Seth van der Meer 44:38
It’s a free trial. Yeah.
Kali Dayton 44:39
Yeah. What a great opportunity to be a part of something great. I know we have lots of students and researchers part of this podcast. So contact Seth that post ico.com. I’ll put all the citations to the studies that you referred to, as well as the links that you’ve mentioned even Dr. E. Lee’s book, on my website where the Transcript of this episode will be also in the show notes. Any last thoughts for the ICU community?
Seth van der Meer 45:05
Yeah, start writing.
Kali Dayton 45:08
Right we could start with a notebook but look at the future there’s we can streamline this process much better.
Seth van der Meer 45:12
Absolutely start writing and the rest will follow.
Kali Dayton 45:16
Thank you so much.
Seth van der Meer 45:17
Thank you. Take care.
Transcribed by https://otter.ai
Citations
Guideline of the Dutch Association of Intensivists.
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