ABSTRACT Background For older adults with critical illness, decisions about life‐sustaining therapies can be challenging. A time‐limited trial (TLT) is a collaborative care plan endorsed by experts in palliative and critical care to help navigate these challenges. TLTs entail trying life‐sustaining therapy for a defined duration. Response to treatment then informs whether to continue recovery‐directed care or shift focus exclusively to comfort. TLTs require collaboration among clinicians, patients, and/or surrogate decision makers, yet there is little practical guidance on how to accomplish this. Thus, we sought to design a collaborative TLT planning tool and characterize its valued characteristics. Methods In this qualitative study framed by human‐centered Design Thinking, we conducted a series of semi‐structured interviews ( n = 25) and focus groups ( n = 5) with 28 participants who were (1) older adults (age ≥ 65) with serious illness, (2) adults of any age with surrogate decision‐making experience for an older adult, and/or (3) intensive care unit (ICU) physicians. We purposively sampled across a Midwestern state to achieve diverse representation and used the Rigorous and Accelerated Data Reduction (RADaR) technique for qualitative analysis. Results We used participants' input to design the ICU Care Plan , a paper‐based tool consisting of a fillable template. The tool is designed to guide a collaborative TLT planning conversation among clinicians, patients, and surrogates and then serve as a visual summary of the care plan. Participants endorsed the tool as (1) creating a unified frame of reference for a complex process; (2) promoting transparency; and (3) setting and managing expectations. The tool exemplifies participants' design priorities of simplicity and flexibility. Conclusions We used a human‐centered design process to develop a tool for in‐the‐moment TLT planning that is endorsed by older adults, surrogates, and ICU physicians. Low technology, intentionally simple interventions are a promising approach to promote patient‐ and family‐centered collaboration.
Mortenson et al. (Mon,) studied this question.