• Louise Rose, Laura Istanboulian, AmaralAndre Carlos Kajdacsy-BallaACKInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada; Sunnybrook Research Institute, Toro, Lisa Burry, Christopher E Cox, Brian H Cuthbertson, Theodore J Iwashyna, Craig M Dale, and Ian Fraser.
• Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK. Electronic address: louise.rose@kcl.ac.uk.
• J Crit Care. 2022 Dec 1; 72: 154153154153.

PurposeFew quality improvement tools specific to patients with persistent or chronic critical illness exist to aid delivery of high-quality care. Using experience-based co-design methods, we sought consensus from key stakeholders on the most important actionable processes of care for inclusion in a quality improvement checklist.MethodsItem generation methods: systematic review, semi-structured interviews (ICU survivors and family) members, touchpoint video creation, and semi-structured interviews (ICU clinicians). Consensus methods: modified online Delphi and a virtual meeting using nominal group technique methods.ResultsWe enrolled 138 ICU interprofessional team, patients, and family members. We obtained consensus on a quality improvement checklist comprising 11 core domains: patient and family involvement in decision-making; patient communication; physical comfort and complication prevention; promoting self-care and normalcy; ventilator weaning; physical therapy; swallowing; pharmacotherapy; psychological issues; delirium; and appropriate referrals. An additional 27 actionable processes are contained within 6 core domains that provide more specific direction on the actionable process to be targeted.ConclusionsUsing a highly collaborative and methodologically rigorous process, we generated a quality improvement checklist of actionable processes to improve patient and family-centred care considered important by key stakeholders. Future research is needed to understand optimal implementation strategies and impact on outcomes and experience.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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