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Policies, bundles, and protocols in critical care 

Policies, bundles, and protocols in critical care
Chapter:
Policies, bundles, and protocols in critical care
Author(s):

Jeffrey Mazer

and Mitchell M. Levy

DOI:
10.1093/med/9780199600830.003.0017
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date: 24 September 2021

Recently, the medicine community has been driven to think about patient safety in new ways, and with this new found interest in patient safety, large health care systems and individual institutions have been forced to develop mechanisms to track and measure performance. There is ample evidence that physicians and systems can do better. The tools of this new craft include checklists, protocols, guidelines, and bundles. These tools help to decrease variability in care and enhance the translation of evidence-based medicine to bedside care. Ongoing measurement of both performance and clinical outcomes is central to this movement. This allows for rapid detection of both successes and possible unintended consequences associated with the rapid translation of evidence into practice. As hospitals and intensive care units (ICU) worldwide have embraced the field of quality improvement (QI), many lessons have been learned about the process. QI includes four essential phases—development, implementation, evaluation, and maintenance. Essential to the QI process and each of these QI phases is that the project must be tailored to each individual ICU and/or Institution. A one-size-fits-all project is less efficient, less effective, and at times unnecessary compare with a locally-driven process.

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