Barriers to and facilitators for implementing a Care Partner program for adult patients with persistent critical illness

Background: Family engagement is critical to patient and family wellbeing in critical care settings, including specialised units for the care of patients with persistent critical illness. Care Partner programs have been introduced in settings such as long-term care and include formal structures (e.g., policies and procedures) to support engagement and collaborative involvement in care among patients, family caregivers, and formal healthcare providers (HCPs). The complexity and acuity of critical care requires early attention to barriers to and facilitators for implementing a Care Partner program intervention to improve family engagement in these settings. Objective: The objective of this study was to describe reported barriers to and facilitators for implementing a Care Partner program in adult persistent critical illness care settings from the perspectives of adult patients, family caregivers, and multiprofessional HCPs. Methods: The study was conducted utilising a qualitative descriptive methodology in a Canadian urban community academic hospital. We conducted 30 semistructured interviews with patients, family caregivers, and HCPs between June 2023 and February 2024. We used content analysis and the social ecological model to analyse findings. Findings: Findings included patient-, family caregiver–, and HCP-reported barriers to and facilitators for Care Partner program intervention implementation mapped to all levels of the social ecological model. Findings include the need for policies regarding visiting during pandemic restrictions and supportive labour policies for family caregivers. Finding also includes ensuring access to mental health services for family caregivers. At the institutional level, orientation programs, access to rest and hygiene spaces, and identification methods for family caregivers were recommended. Creating a welcoming environment and supporting social wellbeing were recommended at the interpersonal level. Intrapersonal-level recommendations included supporting experiential knowledge and endorsing positive attitudes towards family caregivers. Conclusion: The identification of multilevel barriers and facilitators can aid in the design and implementation of interventions addressing structural barriers to family engagement in critical care settings.