Acute care bundles should be used for patients with intracerebral haemorrhage: An expert consensus statement

They can't be 'experts' if they don't know enough to measure 100% recovery!  Survivors want recovery bundles NOT 'care' bundles!

“What's measured, improves.” So said management legend and author Peter F. Drucker 

The latest crapola here:

Acute care bundles should be used for patients with intracerebral haemorrhage: An expert consensus statement

Adrian R Parry-Jones https://orcid.org/0000-0002-4462-3846 adrian.parry-jones@manchester.ac.uk, Susann J Järhult, […], and Joshua N Goldstein+10View all authors and affiliations

OnlineFirst

https://doi.org/10.1177/23969873231220235

• 
  

• • Abstract
  • Introduction
  • Methods
  • Initial evaluation of patients with potential ICH
  • Components of a care bundle for ICH
  • Care bundling
  • Stroke unit care
  • Conclusions
  • Acknowledgments
  • Ethical approval
  • Informed consent
  • Declaration of conflicting interest
  • Funding
  • ORCID iDs
  • Footnotes
  • References
• PDF / ePub
• • Cite article
  • Share options
  • Information, rights and permissions
  • Metrics and citations
  • Figures and tables

Abstract

Purpose:

Intracerebral haemorrhage (ICH) is the most devastating form of stroke and a major cause of disability. Clinical trials of individual therapies have failed to definitively establish a specific beneficial treatment. However, clinical trials of introducing care bundles, with multiple therapies provided in parallel, appear to clearly reduce morbidity and mortality.(But survivors want 100% recovery and you incompetently are not measuring that!) Currently, not enough patients receive these interventions in the acute phase.

Methods:

We convened an expert group to discuss best practices in ICH and to develop recommendations for bundled care that can be delivered in all settings that treat acute ICH, with a focus on European healthcare systems.

Findings:

In this consensus paper, we argue for widespread implementation of formalised care bundles in ICH, including specific metrics for time to treatment and criteria for the consideration of neurosurgical therapy.

Discussion:

There is an extraordinary opportunity to improve clinical care and clinical outcomes in this devastating disease. Substantial evidence already exists for a range of therapies that can and should be implemented now.

Graphical abstract

Introduction

Intracerebral haemorrhage (ICH) represents a major global health burden.¹ Traditionally, the lack of definitive clinical trial data for specific ICH treatments has led to pessimism.² However, recent trials have given cause for optimism for the future of ICH care. The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3) demonstrated that implementation of a goal-directed care bundle reduces the odds of a poor functional outcome.³ A similar care bundle approach has been associated with a significant reduction in mortality in a UK hospital.⁴ These studies suggest that all hospitals and regional acute care systems should now incorporate a care bundle approach when managing patients with ICH. Here, we consider how a care bundle might be implemented.

 

More at link.