ESICM publishes consensus statement on human-centred partnership in the ICU

The European Society of Intensive Care Medicine (ESICM) has published a consensus statement on human-centred partnership in the intensive care unit (ICU) in Intensive Care Medicine. It provides a framework for care that pairs technical excellence with dignity, communication, inclusion, and well-being.

ICUs deliver life-sustaining treatment, but recovery extends beyond physiology. Many survivors experience post-intensive care syndrome, families can experience similar psychological burdens, and ICU professionals face burnout and moral distress. The statement defines human-centred partnership as a mutually beneficial collaboration between clinicians, patients, and families, built on dignity, autonomy, shared decision-making, emotional support, and inclusion.

An international panel of 46 members, including ICU professionals, academics, and patient and family representatives, followed a three-phase, evidence-informed process:

1. Rapid reviews of 20 PICO questions across six domains, producing 53 draft statements.
2. A two-round eDelphi study with 201 participants in round 1 and 149 in round 2, across 47 countries.
3. An expert consensus meeting, in which patients and family representatives held equal standing, resulting in 43 endorsed statements.

Six domains, key recommendations

• Person-centred care: Adopt flexible or unrestricted visitation, establish clear visitation policies, and support active family participation.
• Communication and transparency: Use structured, proactive, interdisciplinary communication, with digital tools as adjuncts to clinician-led communication.
• Emotional well-being: Include family-centred, empathy-focused communication skills in core training, and support staff through debriefing, stress-resilience training, and multimodal programmes.
• Equity, diversity and inclusion: Provide culturally inclusive care, and offer training on inclusivity and implicit bias.
• ICU environment: Consider noise-reduction bundles, earplugs and eye masks, and environmental redesign to support sleep and reduce delirium.
• Technology and innovation: Provide low-technology communication tools to non-vocal patients, consider high-technology options for selected patients, and use virtual visitation alongside, not instead of, in-person presence.

The authors note that evidence is heterogeneous in several domains and that many recommendations rely partly on expert consensus. Eleven statements did not reach consensus and will be reconsidered when the statement is updated, which ESICM plans to do every three years. Future research should prioritise long-term patient- and family-centred outcomes and implementation science.

Human-centred partnership requires cultural and organisational change, supported by leadership, interdisciplinary collaboration, adequate staffing, and education. Technology should complement, not replace, direct interpersonal relationships.