Gender equality and equity in intensive care: an international Delphi consensus study

Abstract

PURPOSE: We used Delphi methodology to provide guidance on gender equality and equity issues in professional life in intensive care, where information is evolving and no clear standard exists. METHODS: A 12-member Steering Committee (7 women, 5 men) from 7 countries and 46 international panelists [(23 women, 21 men, 2 preferred not to disclose; median age 52 (33-75) years] from 32 countries (43% low- and middle-income) including intensive care practitioners, scientists, researchers, and trainees voted on 57 statements addressing issues related to gender equality and equity in 10 domains of professional life. Delphi rounds were conducted using online surveys. Consensus (at least 75% of panelists voting for a response option) and stability (consistent responses on iterative rounds) were assessed. RESULTS: Six Delphi rounds were conducted between May and July 2025. A 100% response rate was achieved in each round. Consensus and stability were achieved on 43 (75%) of 57 statements from which 37 professional practice guidance statements were developed. Across domains, greater consensus was achieved on equality [23/27 (85.2%)] versus equity [12/18 (66.7%)] statements. Discordant equity statements primarily pertained to academia and engagement in multiprofessional meetings and the workplace. CONCLUSION: Using a Delphi method, international experts reached consensus to generate 37 professional practice guidance statements. The consensus statements provide needed guidance for professional engagement and highlight areas for policy development to advance gender equity and equality for healthcare workers in intensive care. The discordant statements highlight areas for future research.