32. Implement and Monitor Care Bundle

Have you identified what types of user problems could benefit from a Care Bundle?

Have you thought together about Care Bundles in a team away day?

Have you written the Care Bundle in a quick, easily accessed form?

Do you monitor compliance frequently, at least every time the family is seen?

Are the collated results from all the families on Care Bundles regularly reviewed by clinicians and as a team?

Do you act on the results of the monitoring?

Could a user tell you what their Care Bundle was?

Are you doing the agreed bundle?

Rationale

Even if you agree what you should be doing, without a monitoring process it probably isn’t happening. In contrast to audit, monitoring should be done as you go along rather than retrospectively. A simple example of a Care Bundle for ADHD could be:

  • Multidisciplinary assessment, School information, baseline Parent Conners and Teacher Conners
  • Stimulant treatment: Initiation: Height, Weight, BP, Pulse, Physical examination, Parent Conners, Teacher Conners, Side effects rating scale, Info re medication
  • Follow up: Height, Weight, BP, Pulse, Parent Conners, Teacher Conners, Side effects rating scale as minimum every 4 months
  • Shared Care agreement with GP
  • Psycho-education
  • Parent skills training over 12 sessions
  • School behaviour management package
  • Individual problem solving skills
  • Minimum 6 monthly psychosocial review

This could be devised to suit the team and users and placed as a checklist in the file, to ensure easy monitoring of compliance and progress.

Ideas for Action

  • Measure compliance with care bundle as part of routine e.g. use simple, easy to complete checklists that are in the notes that can be completed as treatment progresses.
  • Monitor compliance frequently and give feedback to the team.