BEYOND PICS: a conceptual framework for post-ICU recovery stewardship
Year: 2026
Type: article
Abstract: As survival from critical illness improves, the global burden of post-intensive care syndrome (PICS) and PICS-family continues to grow, reshaping the goals of modern intensive care. Despite growing awareness, prevention, follow-up and rehabilitation remain fragmented, and important gaps persist in the organisation of recovery-oriented care. We propose BEYOND PICS, a conceptual framework for ICU survivorship built around six complementary pillars: Begin before ICU discharge , Early follow-up and equitable access , Your journey , Ongoing multidomain assessment and rehabilitation , Networked care , and Driving improvement . Rather than describing clinical interventions to be implemented in practice, the framework promotes a coordinated recovery pathway integrating prevention, patient partnership, education, rehabilitation, multidisciplinary collaboration and continuous quality improvement across the peri-ICU continuum. BEYOND PICS is not a clinical bundle or guideline, it provides a mental model to guide the organization of care, integrating the key components of ICU survivorship into a coherent continuum of care while highlighting priorities for future research.
Source: Critical Care
Authors: Anne-Françoise Rousseau, Susannah Leaver, Teresa Cardoso, Sabrina Eggmann, Bertrand Guidet, Martina Hermann, Cheryl E. Hickmann, David McWilliams, Marlies Ostermann, Simone Piva, Christian Stoppe, Margo van Mol, Jan De Waele, Bjoern Weiss, Michael Beil, Stefan J Schaller, for the ESICM HSRO, FREM NAHP, PICS&Rehab Sections
Institutions: University of Liège, Centre Hospitalier Universitaire de Liège, McGill University, Universidade do Porto, Hospital Padre Américo, Instituto de Ciências Biomédicas Albel Salazar, University of Zurich, University Hospital of Bern, University Children's Hospital Zurich, Monash University, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Antoine, Medical University of Vienna, Haute École Provinciale de Hainaut Condorcet, Epicura, Coventry University, King's College London, Guy's and St Thomas' NHS Foundation Trust, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Brescia, Humboldt-Universität zu Berlin, Universitätsklinikum Würzburg, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Erasmus MC, Ghent University Hospital, Ghent University, NHS Highland
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,190
OpenAlex ID: W7204235337
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