Doing time in an Australian ICU; the experience and environment from the perspective of patients and family members

Aust Crit Care. 2021 May;34(3):254-262. doi: 10.1016/j.aucc.2020.06.006. Epub 2020 Sep 14.


Background: The intensive care environment and experiences during admission can negatively impact patient and family outcomes and can complicate recovery both in hospital and after discharge. While their perspectives based on intimate experiences of the environment could help inform design improvements, patients and their families are typically not involved in design processes. Rather than designing the environment around the needs of the patients, emphasis has traditionally been placed on clinical and economic efficiencies.

Objective: The main objective was to inform design of an optimised intensive care bedspace by developing an understanding of how patients and their families experience the intensive care environment and its impact on recovery.

Methods: A qualitative descriptive study was conducted with data collected in interviews with 17 intensive care patients and seven family members at a large cardiothoracic specialist hospital, analysed using a framework approach.

Results: Participants described the intensive care as a noisy, bright, confronting and scary environment that prevented sleep and was suboptimal for recovery. Bedspaces were described as small and cluttered, with limited access to natural light or cognitive stimulation. The limited ability to personalise the environment and maintain connections with family and the outside world was considered especially problematic.

Conclusions: Intensive care patients described features of the current environment they considered problematic and potentially hindering their recovery. The perspective of patients and their families can be utilised by researchers and developers to improve the design and function of the intensive care environment. This can potentially improve patient outcomes and help deliver more personalised and effective care to this vulnerable patient population and their families.

Keywords: Delirium; Environment; ICU redesign; Ideal ICU; Light; Noise; Patient experience; Patient interviews; Patient outcomes; Personalised care.

MeSH terms

  • Australia
  • Critical Care
  • Critical Illness*
  • Family
  • Humans
  • Intensive Care Units*
  • Qualitative Research