Patient, Family and Provider Priorities in ICU Rehabilitation: An Experience-Based Co-Design Study

Intensive care unit (ICU) rehabilitation has been shown to improve physical, psychological and functional outcomes in critically ill patients. However, implementation varies widely, and clinical practice guidelines (CPGs) are needed to ensure consistent, evidence-based care. Incorporating patient and public involvement (PPI) into CPG development is essential to reflect the lived experiences and priorities of service users.

To explore the experiences of ICU rehabilitation from the perspectives of patients, families and healthcare providers and to identify shared priorities that can inform the development of Korean CPGs for ICU rehabilitation and post-intensive care syndrome.

This study applied the Experience-Based Co-Design (EBCD) approach. We conducted observations of ICU rehabilitation practices through institutional educational video recordings, individual interviews with four ICU survivors and a focus group interview with five ICU healthcare professionals. A trigger audio recording, derived from the patient interviews, and thematic touchpoints from qualitative analysis were presented in a group feedback event. ICU clinicians involved in CPG development participated to validate the findings and identify shared priorities.

Four core priorities were identified: patients and families as partners, person-centred approach, fostering rehabilitation culture and teamwork, and ensuring sustainability of rehabilitation.

Successful ICU rehabilitation requires placing patients and families at the centre throughout the entire rehabilitation journey, from ICU admission to community reintegration. Structural support addressing workforce limitations and cost reimbursement issues, complemented by a culturally sensitive team approach, is essential for establishing effective linkages between ICU rehabilitation and community services.

ICU healthcare providers should create more opportunities for patient and family engagement in rehabilitation processes. A dynamic team approach that flexibly incorporates diverse staff is crucial for delivering person-centred services. Administrators and policymakers should develop comprehensive strategies and policies that facilitate seamless continuation of rehabilitation from ICU to community settings.