{"doi":"10.1111/jgs.70155","title":"The <scp>ICU</scp> Care Plan: Human‐Centered Design of a Tool to Support Time‐Limited Trials for Older Adults With Critical Illness","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.","journal":"Journal of the American Geriatrics Society","year":2025,"id":577761,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9602,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1487556,"name":"Josephine M. McCartney","orcid":null,"position":1,"is_corresponding":false},{"id":1302923,"name":"Joy X. Moy","orcid":null,"position":2,"is_corresponding":false},{"id":1302556,"name":"Geralyn Palmer","orcid":"0000-0001-5119-910X","position":3,"is_corresponding":false},{"id":1487557,"name":"Jaime Goldberg","orcid":null,"position":4,"is_corresponding":false},{"id":375436,"name":"Demetrius Solomon","orcid":null,"position":5,"is_corresponding":false},{"id":1487558,"name":"Madison Polley","orcid":null,"position":6,"is_corresponding":false},{"id":1487559,"name":"Neera Grover","orcid":null,"position":7,"is_corresponding":false},{"id":700371,"name":"Margaret L. Schwarze","orcid":"0000-0001-7063-906X","position":8,"is_corresponding":false},{"id":932851,"name":"Toby C. Campbell","orcid":"0000-0003-4910-1112","position":9,"is_corresponding":false},{"id":371011,"name":"Jane L. Holl","orcid":"0000-0002-2934-1672","position":10,"is_corresponding":false},{"id":453735,"name":"Sarah Esmond","orcid":null,"position":11,"is_corresponding":false},{"id":553697,"name":"Jacqueline M. Kruser","orcid":"0000-0003-3258-1869","position":12,"is_corresponding":false},{"id":1302925,"name":"S. Mortenson","orcid":null,"position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-19T02:58:16.148027Z","pmid":"41081376","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}