Clinicians' perceptions on implementation strategies used to facilitate ABCDEF bundle adoption: A multicenter survey.
Audrey Brockman, Anna Krupp, Christina Bach and 5 others
PMID 37399777WHAT IT FOUND
ICU sites reported using 63 of 73 implementation strategies to adopt the ABCDEF bundle, commonly with education and reminders.
Financial strategies were rarely used and rated not feasible.
Key findings
01Across 19 ICU sites, 63 of the 73 ERIC implementation strategies were used to increase adoption of the ABCDEF bundle.
02Educational meetings were reported by 94.7% of sites, ongoing training by 89.5%, and reminding clinicians by 84.2%.
03Financial strategies were used by three sites for funding or contracting and one site for incentives, and were rated not-at-all feasible on a 5-point scale.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The response rate was 27.9%, and only 19 sites completed the full survey. All sites had previous participation in the SCCM ICU Liberation Collaborative, so findings may not apply to ICUs unfamiliar with the ABCDEF bundle. Participants reported perceptions of strategies used, not direct measures of strategies used during implementation or practice change. The survey could require 73 to 365 questions, which may have lowered response. Clinical expert end-users may be unfamiliar with implementation strategies, which may have made reported strategy use subjective.
Declared interests
The supplied metadata indicates NIH extramural and non-US government research support. Dr. Balas declared that she is current Co-Chair of the SCCM PADIS guideline update, a member of the American Psychiatric Association Delirium Guideline Writing Group, and has served as a consultant for Ceribell.
The easy way to misread this
Do not read this as evidence that education, training or reminders improve patient outcomes or bundle adoption. The study asked clinicians to report perceived strategy use and ratings, did not directly measure implementation during practice change, and had a low response rate.