Innovation in intensive care: a framework to turn ideas and concepts into actionable solutions

Introduction: Intensive care is under increasing pressure due to demographic changes, availability of new complex therapies, and workforce shortages, resulting in a relative reduction in resources. Technological advances such as digitalization, wearable sensors, and artificial intelligence promise to improve care delivery, enabling providers to offer equal or higher-quality care at lower costs. However, no healthcare system has yet demonstrated large-scale gains in the efficiency of intensive care delivery. A central requirement is the capacity to translate ideas and concepts into value, providing changes that make services, products, and optimal care more accessible and affordable to a larger population, generating value. Innovation should thus be acknowledged as a fourth principal pillar of intensive care, alongside clinical excellence, research, and teaching. Methods: This paper presents the opinion of a multidisciplinary expert panel, proposing a framework to support the generation, implementation, and evaluation of innovation in intensive care. Results: We identify and examine key areas and applications where innovation is urgently needed, including workforce development, technology adoption, environmental sustainability, and the transformation of medical education. We also highlight barriers and concerns that must be addressed when implementing innovation in ICUs. We integrate these into a comprehensive framework illustrated through concrete examples. Finally, we argue that innovation should not be driven solely by academia or industry, but strategically led by healthcare professionals and patients’ representatives, grounded in ethics and data, interdisciplinary, and centered on patients’ and society’s needs. Conclusion: This framework offers a pathway for innovation, supporting a more inclusive, effective, and sustainable future for intensive care. Visual abstract: (Figure presented.)