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Implementation and guidance

Implementation follows five phases.

On joining the AMBER network, hospitals are supported to implement AMBER care bundle. Engagement, preparation, identifying resources to support change and understanding risks around sustainability are important planning strategies.


A “bundle” is a small set of evidence-based interventions for a defined patient population and care setting. The feature of a care bundle is that the focus is on "all or nothing" so that success is demonstrated by a patient receiving all core elements of evidence based care. 

”Implementing a bundle with high reliability requires redesign of work processes, communication strategies, and infrastructure, along with sustained measurement and vigilance. Bundles are neither “magic bullets” nor comprehensive care for any condition or patient situation; rather, they are one strategy among many that hospitals must implement in order to prevent serious complications in their patients — and save lives." 

From:  Resar R, Griffin FA, Haraden C, Nolan TW. Using Care Bundles to Improve Health Care Quality. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2012.
(Available on www.IHI.org)

Staff training and development

The main training and development needs for staff involve:

  • Identifying people whose potential for recovery is uncertain and communicating concerns to members of the clinical team
  • Effective communication skills, in having difficult or sensitive conversations with patients and their families

Hospitals employ a number of different approaches in training such as one-to-one teaching on the ward as well as more formal lectures. The important thing is to have somebody that the staff can contact with queries and who can support them with sensitive conversations.


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