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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).
Effect of Nonpayment for Preventable Infections in US Hospitals
This study examined rates of healthcare-associated infections deemed preventable by the Centers for Medicare & Medicaid Services, such as catheter-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonias.
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.
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.
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.
Impact of the ventilator bundle on ventilator-associated pneumonia in intensive care unit
This article examines the adoption of the ventilator bundle elements to prevent adverse events in ventilated patients, including ventilator-associated pneumonia, in 415 ICUs in 250 US hospitals.
Passport Exclusive: Taking Steps to Improve Patient Mobility
This video describes the effects of early activity for patients in the intensive care unit.
Passport Exclusive: Developing, Testing, and Locally Adapting Sedation Protocols
In this video, IHI faculty member Dr. Terry Clemmer details the steps to develop and test a sedation protocol at your organization.
Changes to Prevent Healthcare-Associated Infections
Organizations must test and implement changes to existing processes in order to prevent healthcare-associated infections (HAIs).
JAMA Patient Page: Ventilator-associated pnuemonia
This resource presents information on risk factors, prevention, diagnosis and testing, and treatment of ventilator-associated pneumonia.
Annotated Bibliography for Preventing Ventilator-Associated Pneumonia
This annotated bibliography presents selected literature for the elements of the IHI Ventilator Bundle and preventing ventilator-associated pneumonia.
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 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.
Improving Flow without Adding Resources: A Success Story
In March 2002, Baptist Memorial Hospital-Memphis was convinced its capacity problems were intractable. Two years later, they’ve dramatically increased flow and patient satisfaction, and decreased length of stay and mortality — all without hiring any more staff or adding a single bed.
Multidisciplinary Rounds: Not MORE Work, But THE Work
Implementation of multidisciplinary rounds at Baptist Memorial Hospital - Memphis (Memphis, Tennessee, USA) facilitated collaborative patient care planning and implementation of evidence-based practices resulting in improved patient outcomes, including decreased length of stay (LOS), decreased mortality rate, decreased ventilator days and decreased rates of ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CR BSI) and urinary tract infections (UTI).
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.
Doing Better, Spending Less
Hospitals throughout the country are saving lives and reducing costs by eliminating central line infections and the complications associated with them.
Swedish Medical Center Reduces Mortality Rate by Nineteen Percent
Swedish Medical Center has mounted a full court press on mortality in all three hospitals in its network: their unadjusted mortality rate dropped from an already low 2.1 percent in 2001 to 1.7 percent in mid-2005.
Allegheny General Hospital: Lower Infection Rates Have Lowered Costs
The human and financial cost of hospital-acquired infection is huge. At Allegheny General Hospital, a 580-bed teaching hospital, a sharp focus on preventing infection has resulted in significant savings in both categories.
Reducing Complications from Ventilators and Central Lines at Swedish Medical Center
Swedish Medical Center's Adult ICU team has spread ventilator-associated pneumonia rate improvements made in their Medical ICU to include a total of six ICUs.
Applying Toyota Production System Principles in a Critical Care Unit
Virginia Mason Medical Center tested and adapted Toyota Production System principles in its Critical Care Unit, leading to more highly reliable and safer bedside care.
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.
Reducing Hospital-Acquired Infections in a Long-Term Acute Care Hospital
Windy Hill Hospital (Marietta, Georgia, USA) has significantly reduced the number of hospital-acquired infections caused by MRSA, VRE, and C. difficile by implementing admission surveillance cultures and improving hand hygiene, among other improvements.
Reducing Length of Stay in Intensive Care
Conwy and Denbighshire NHS Trust have halved the average length of stay in the ICU and consequently increased patient throughput by 33.5 percent.