​Among the many joys of my near decade as an IHI Director, my relationship with the faculty of our Rethinking Critical Care seminar is among the highest. This seminar brings together Dr. Terry Clemmer from Intermountain Healthcare, Vicki Spuhler, RN, retired from Intermountain, and Dr. Wes Ely of Vanderbilt University. Together, they are a tour de force working together to help clinicians reduce sedation, decrease delirium, and increase mobility for critically ill patients.

We were together in March 2013 to teach this seminar and our time together started a conversation about bundles that continued on email as Wes posed some very interesting questions to Terry, Vicki, and me about the history and philosophy of bundles. He read the IHI white paper, Using Care Bundles to Improve Health Care Quality, and wanted some additional clarification.

The resulting exchange proved enlightening since Terry and Vicki were on the ground floor of bundle development over a decade ago and remember the history well. We decided to share this conversation with the hope that it may clarify questions for other clinicians as well.

— Kelly McCutcheon Adams, LICSW, IHI Director