A bundle is a set of evidence-based interventions that, when performed consistently and reliably, has been shown to improve outcomes and safety in health care. A bundle is typically comprised of a small number of clinical practices (usually 3-5) which are supported by scientifically robust clinical evidence that are all performed cohesively for maximal impact. Examples include bundles to improve maternal care and timing identification and treatment of sepsis.
Best practices in health care as considered the ‘best way’ to identify, collect, evaluate, and disseminate information; implement practices; and/or and monitor the outcomes of health care interventions for patients or population groups with defined indications or conditions. The term “best practices” is somewhat controversial, as some “best practices” may not be supported by rigorous evidence. Therefore, there has been a transition to using “evidence-based practice” or the “best available evidence” to demonstrate that the practice is grounded in empirical research. Examples of evidence-based best practices include surgical pre-op checklists, sepsis bundles, and reducing the use of indwelling catheters.
Accountability in healthcare represents the procedures and processes by which one party justifies and takes responsibility for its activities. This can be both at an individual and organizational level. Individuals must be held accountable for their actions, but organizations also play a role and must also be accountable for their structures and systems.
Organizational accountability is dependent upon a safety culture that accepts that adverse events and medical errors should lead to organizational learning (as opposed to a punitive culture in which an organization places blame on individuals rather than making systematic changes based on learning from the errors). When individual errors are made, it is important that organizations separate human behaviors that fall into the reckless (conscious disregard) and intentional categories versus behaviors that reflect human error (e.g., should have done something different) or negligence (failure to exercise expected care). Human error and negligent errors are typically the result of lack of knowledge, misremembering, or misplaced priorities.
Institute for Safe Medication Practices.
J Med Imaging Radiat Oncol. 2022;66(2):165-309.