ABCDEF Bundle Improvement Collaborative

The ICU Liberation ABCDEF Bundle Improvement Collaborative is now closed. The Collaborative worked with hospital teams to optimize pain control and reduce sedative exposure and time on mechanical ventilation. Participating hospitals worked to:

  • Increase length of time that patients are free of delirium and coma
  • Improve team approach to early mobilization
  • Engage families to participate in the care and healing of their loved ones
  • Validate compliance and improvement through use of an online data collection tool
  • Enhance teamwork through implementation of evidence-based care
  • Engage with many leading experts who have demonstrated improved patient outcomes through the ABCDEF bundle of care
  • Create partnerships with other institutions doing the same improvement work across the United States

The Collaborative, funded by the Gordon and Betty Moore Foundation​, was operating in three regions: the Southeast, the West Coast and the Midwest. ICUs of any type or size applied with no experience implementing the bundle required. The collaborative teams collected data and use that data to inform of reductions in ICU length of stay, hours on the ventilator and improvement  in team communication and interaction. Learn more by listing to an SCCM iCritical Care Podcast​ on the topic.


 Pediatric Collaborative


Members Only - Access the Collaboratives

Members of the Pediatric ICU Liberation Collaborative may access the Committees/Collabratives eCommunity to share information, discuss issues via the Discussion List serv and get up to date on events and happenings.

Pediatric ICU Liberation Collaborative
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Pediatric ICU Liberation Collaborative Overview

The Pediatric ICU Liberation Collaborative aims to:

1. Describe implementation strategies and fidelity for each bundle element

  • Bundle elements are to be discussed daily on rounds

2. Describe the impact of individual Describe the impact of individual / entire bundle implementation on PICU outcomes

  • Outcomes of Interest:
    o Duration of PICU stay
    o Duration of mechanical ventilation
    o Delirium incidence based on central auditory processing disorder screening
    o Functional Status
    o Family satisfaction
    o Enumeration of adverse events potentially associated with ABCDEF Bundle implementation
     - Inadvertent endotracheal tube, Vascular catheter, Bladder catheter removal
     - Falls
     - Failed tracheal extubatiom

3. Describe resource utilization in implementation and maintenance

  • Number of patients receiving therapy services such as physical, occupational, speech, child life, music, etc.
  • Number of therapy contact hours per patient (ideally, therapy intensity × duration)
  • Number of administrative and education hours spent in development, dissemination, implementation and maintenance of the ABCDEF bundle
  • Changes to nurse staffing (number of nurses per shift per patient)
  • End-of-intervention survey directly addressing resource utilization to implement and maintain the PICU Liberation ABCDEF bundle


Timeline of Events
August 2015 – Start of collaborative/Data collection begins
November 2016 – Interim meeting to discuss progress with participating sites
June 2017 – Data collection ends
July/August 2017 – Publication of results


 Collaborative Registration

​The ABCDEF Collaborative is now closed and no new ICUs are being accepted. Content from the collaborative will be posted on this website as open-access materials for any ICU team to use.​​​​