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Using Care Bundles to Improve Health Care Quality
This IHI white paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles — a small set of evidence-based interventions for a defined patient population and care setting — and reflects on learning over the past decade.
WIHI: A Partnership to Reduce Deaths from Sepsis
January 24, 2013 | This WIHI explores how North Shore–Long Island Jewish Health System has reduced its sepsis mortality rate significantly, and what others can learn from their progress.
WIHI: No Excuses, No Slack! The Latest from the Front Lines on Hand Hygiene
March 7, 2013 | This WIHI discusses recent innovations in hand hygiene with experts from facilities that have had success in achieving nearly universal compliance.
WIHI: All Hands on Deck to Reduce C. Difficile
April 9, 2015 | Where is progress being made to reduce instances of C. difficile, and where does more aggresive work need to be done?
How-to Guide: Prevent Central Line-Associated Bloodstream Infection
This How-to Guide describes key evidence-based care components of the IHI Central Line Bundle which has been linked to prevention of central line-associated bloodstream infections, describes how to implement these interventions, and recommends measures to gauge improvement.
How-to Guide: Prevent Ventilator-Associated Pneumonia
This How-to Guide describes key evidence-based care components of the IHI Ventilator Bundle which has been linked to prevention of ventilator-associated pneumonia.
How-to Guide: Reduce MRSA Infection
This How-to Guide describes key evidence-based care components for reducing methicillin-resistant Staphylococcus aureus (MRSA) infections, describes how to implement these interventions, and recommends measures to gauge improvement.
One Is Too Many: Viewing Infection Data from the Patient's Perspective
A surgical patient who contracted MRSA following knee replacement surgery describes the effects of the surgical site infection (SSI) on her life, and how her experience led her health care providers to make changes to prevent SSIs.
Severe Sepsis Bundles
The Severe Sepsis Bundles include the Severe Sepsis 3-Hour Rescuscitation Bundle and the 6-Hour Septic Shock Bundle. The Severe Sepsis Bundles have been revised in conjunction with the updated 2012 International Guidelines for Management of Severe Sepsis and Septic Shock.
Contra Costa Regional Medical Center: Where the Rate of VAP Dropped By More Than 90 Percent through Collaborative Efforts
At Contra Costa, a conscious effort from the top down and the bottom up creates a culture of collaboration and teamwork. Teamwork has enabled improvement of care processes and patient outcomes in many areas, including VAP.
Methods for Reducing Sepsis Mortality in Emergency Departments and Inpatient Units
North Shore-LIJ Health System (now Northwell Health) launched a strategic partnership with the Institute for Healthcare Improvement to accelerate the pace of sepsis improvement, focusing initially on sepsis recognition and treatment in emergency departments (EDs). The health system reduced overall sepsis mortality by approximately 50 percent in a six-year period and increased compliance with sepsis resuscitation bundle elements in the EDs and inpatient units in 11 acute care hospitals.
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.
How-to Guide: Prevent Catheter-Associated Urinary Tract Infection
This How-to Guide describes key evidence-based care components for preventing catheter-associated urinary tract infections, describes how to implement these interventions, and recommends measures to gauge improvement.
Incidence of Severe Hypoglycemic Episodes
The aim is to achieve glucose control less than 180 mg/dl in 100 percent of critically ill patients without increased incidence of severe hypoglycemia
Glycemic Control Goal
Current literature suggests appropriate glycemic control in the ICU reduces morbidity and overall mortality in the critically ill.
Ventilator Bundle Compliance
Compliance with the Ventilator Bundle is defined as the percentage of intensive care patients on mechanical ventilation for whom all four of the elements of the Ventilator Bundle are documented on daily goals sheets and/or elsewhere in the medical record.
Ventilator-Associated Pneumonia (VAP) Rate per 1,000 Ventilator Days
Ventilator-associated pneumonia (VAP) is defined as pneumonia in a patient intubated and ventilated at the time of or within 48 hours before the onset of the event. (There is no minimum period of time that the ventilator must be in place in order for the pneumonia to be considered ventilator-associated.) The VAP rate is defined as the number of ventilator-associated pneumonias per 1,000 ventilator days
Sepsis Care Enters New Era
They are principles key to transforming health care: teamwork and adherence to standards. In a demonstration of exactly these qualities, a worldwide movement, the Surviving Sepsis Campaign, in partnership with the Institute for Healthcare Improvement, is breaking new ground in a battle against an elusive foe.
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.
First Steps and Measures to Reduce Sepsis Mortality
University of Rochester/Strong Health (Rochester, New York, USA) implemented the 2004 Surviving Sepsis Campaign clinical practice guidelines, using a previous iteration of the Sepsis Bundle to decrease septic patients’ overall mortality.
How-to Guide: Reduce MRSA Infection — Rural Hospitals Supplement
This How-to Guide specifically tailored for rural hospitals describes key evidence-based care components for reducing methicillin-resistant Staphylococcus aureus (MRSA) infections, describes how to implement these interventions, and recommends measures to gauge improvement.
How-to Guide: Reduce MRSA Infection — Pediatric Supplement
This How-to Guide specifically tailored for pediatrics describes key evidence-based care components for reducing methicillin-resistant Staphylococcus aureus (MRSA) infections, describes how to implement these interventions, and recommends measures to gauge improvement.
How-to Guide: Prevent Ventilator-Associated Pneumonia (Pediatric Supplement)
This How-to Guide specifically tailored for pediatrics describes key evidence-based care components for preventing ventilator-associated pneumonia.
How-to Guide: Prevent Central Line-Associated Bloodstream Infection (Rural Hospital Supplement)
This How-to Guide is specifically tailored for rural hospitals and describes key evidence-based care components for preventing central line-associated bloodstream infections, describes how to implement these interventions, and recommends measures to gauge improvement.
How-to Guide: Improving Hand Hygiene
This How-to Guide is designed to help organizations reduce healthcare-associated infections, including infections due to antibiotic-resistant organisms, by improving hand hygiene practices and use of gloves among health care workers.