Improving Health Care for Critically Ill Patients Using an Evidence-Based Collaborative Approach to ABCDEF Bundle...

Area of Science:

• Critical Care Medicine
• Implementation Science
• Healthcare Improvement

Background:

• Intensive care units (ICUs) commonly lead to postintensive care syndrome (PICS) due to pain, oversedation, delirium, and weakness.
• Addressing PICS requires evidence-based interventions and effective team-based approaches.
• Bridging the gap between evidence and practice is crucial for improving ICU patient outcomes.

Purpose of the Study:

• To describe the Society of Critical Care Medicine's (SCCM) ICU Liberation ABCDEF Bundle Improvement Collaborative.
• To detail the evidence-based implementation strategies used to promote change and teamwork.
• To outline the performance and outcome metrics for monitoring progress in applying the ABCDEF bundle.

Main Methods:

• Collaborative participants engaged in in-person meetings, co-learning calls, and database training.
• Teams submitted patient-level data and completed questionnaires on teamwork, work environment, and ICU care.
• Faculty shared evidence supporting each bundle element and team-based implementation strategies.

Main Results:

• High retention rates were observed, with most adult and pediatric ICUs completing the program.
• Over 17,000 critically ill patients had baseline and prospective data collected.
• A range of evidence-based behavioral change interventions and implementation techniques were employed.

Conclusions:

• The Collaborative structure, strategies, and tools can guide hospitals in implementing the ABCDEF bundle.
• Successful implementation of the ABCDEF bundle can improve ICU care and mitigate PICS.
• This model supports the adoption of evidence-based practices in critical care settings.