Understanding family experience in the paediatric intensive care unit: Development of the 3Cs Framework

INTRODUCTION: Admission to the paediatric intensive care unit (PICU) can be a distressing experience for children and their families, with potential long-term impacts associated with post-intensive care syndrome. While increasing attention has been given to family experience in the PICU, the role of the physical environment in shaping these experiences remains underexplored. Design thinking offers an approach to engage stakeholders and explore complex healthcare challenges. OBJECTIVE: The aim of this study was to understand the experiences of families of children in the PICU in order to inform the design of more therapeutic and responsive healthcare environments. METHODS: This qualitative study used design thinking-informed engagement strategies to explore family and clinician experiences of the PICU environment. The study was conducted through a collaborative partnership between clinicians, designers, and families. Data were collected through designer immersion, interviews, participatory engagement activities, and visual artefacts. Data were analysed using reflexive thematic analysis. RESULTS: Approximately 50 clinicians and 40 family members participated in the study. Thematic analysis identified three core themes central to family experience in the PICU: Care, Comfort, and Connect. These themes informed the development of the 3Cs Framework, which articulates key spatial and experiential needs of families. The framework was subsequently applied to guide conceptual spatial design recommendations for the PICU. CONCLUSIONS: The findings highlight the importance of considering care, comfort, and connection in the design of PICU environments. The 3Cs Framework provides a structured way to translate family experience into design considerations and may support the development of more therapeutic healthcare spaces.