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Understanding Bundles: An IHI Faculty Conversation
IHI faculty for the Rethinking Critical Care seminar discuss and try to clarify some important and often misunderstood points about implementing care bundles (such as the Ventilator Bundle and the Central Line Bundle).
Profiles in Improvement: Katharine Luther, Vice President, IHI
IHI Vice President Kathy Luther describes her career in health care quality improvement, and how her current IHI work includes getting finance and clinicians to work together to impact cost and quality.
A Team Gives Mobility to Ventilated Patients
Patients in critical care are usually kept immobile and heavily sedated, but there’s growing evidence that mobility can help a patient's long-term recovery.
Zero VAP Rate in the ICU by Reducing Time on Sedation
Mercy Hospital (Buffalo, New York, USA) has sustained zero ventilator-associated pneumonias in the ICU by reliably implementing the IHI Ventilator Bundle, with a special focus on reducing the amount and duration of sedation for patients on ventilators in the ICU.
Bundle Up for Safety
This story describes and explains the term "bundle," which applies to collections of processes needed to effectively care for patients undergoing particular treatments with inherent risks.
Creating and Implementing a Bundle to Reduce VAP in the NICU
Central DuPage Hospital reduced VAP in the NICU from a rate of 13.02 in 2004 to a rate of 5.43 in 2005 by implementing a neonatal ventilator bundle, reducing accidental extubations and a reinforcing handwashing.
What Is a Bundle?
IHI Vice President and patient safety expert, Carol Haraden, PhD, clarifies what a "bundle" is and is not, and suggests tips for using bundles most effectively to get results in improvement initiatives. While the allure of this tool is undeniable, says Haraden, quality teams should resist the impulse to label any list of good changes a bundle.
Early Goal Directed Therapy Reduces Sepsis Complications and Mortality
At PeaceHealth/St. Joseph Hospital (Bellingham, Washington, USA), a partnership between the ICU and the ED, as well as ongoing surveillance and feedback to individual providers, reduced mortality related to severe sepsis and septic shock from 41 to 50 percent in the two months prior to implementation to an average of 17 percent after implementation of the Sepsis Resuscitation and Sepsis Management Bundles.
Reducing Average Length of Stay on Mechanical Ventilation Using Bundles and Mobility
University of Rochester Medical Center targeted specific elements in the Ventilator and Central Line Bundles to increase compliance, thereby reducing ventilator-associated pneumonia, reducing CRBSIs, and decreasing average length of stay. In addition, a mobility initiative helped the team achieve daily sedation interruption and development of a new bundle further reduced CRBSIs.