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Point/Counterpoint Editorials |

Point: Are the Best Patient Outcomes Achieved When ICU Bundles Are Rigorously Adhered To? YesBest Outcomes When ICU Bundles Used? Yes

R. Phillip Dellinger, MD, FCCP; Sean R. Townsend, MD, FCCP
Author and Funding Information

From the Cooper Medical School of Rowan University (Dr Dellinger); Cooper University Hospital (Dr Dellinger); California Pacific Medical Center (Dr Townsend); and University of California, San Francisco (Dr Townsend).

Correspondence to: R. Phillip Dellinger, MD, FCCP, Cooper Health System, CCM Section-3rd Floor Dorrance, 1 Cooper Plaza, 383 Dorrance, Camden, NJ 08103; e-mail: dellinger-phil@cooperhealth.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Drs Dellinger and Townsend have leadership roles in the Surviving Sepsis Campaign, an organization that espouses the use of a sepsis bundle in the management of severe sepsis.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(2):372-374. doi:10.1378/chest.13-0846
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Extract

ICU bundles have emerged as important tools in addressing clinical health-care conditions with evidence-based medicine. An ICU bundle is a set of treatment goals (usually three to seven) that when grouped and achieved together over a finite time span are believed to promote optimum outcomes. The Institute for Healthcare Improvement (IHI) has been one of the main proponents of the bundle concept. Bundle-based care is based on evidence-based medicine. Bundles exist for the prevention of surgical site- and catheter-associated central line infections as well as for the prevention of urinary tract infections, weaning from ventilation, promotion of palliative care, treatment of sepsis, and prevention of pressure ulcers. ICU protocols standardize the implementation of bundle care components. A primary advantage of bundle care is the structuring of care processes to promote consistency in the management of clinical conditions.3 Large collaborative groups, such as the Michigan Health & Hospital Association Keystone ICU, VHA Inc (Voluntary Hospital Association), and the Institute for Healthcare Improvement 5 Million Lives Campaign, have shown improved care and better patient outcomes with the use of bundles.4

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