ABCDEF bundle performance showed significant and clinically meaningful improvements in outcomes including survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge disposition. Complete ABCDEF bundle performance was associated with lower likelihood of seven outcomes: hospital death within 7 days, next-day mechanical ventilation, coma, delirium, physical restraint use, ICU readmission, and discharge to a facility other than home. We defined ABCDEF bundle performance (our main exposure) in two ways: 1) complete performance (patient received every eligible bundle element on any given day) and 2) proportional performance (percentage of eligible bundle elements performed on any given day). The goal of this study was to evaluate the relationship between ABCDEF bundle performance and patient-centered outcomes from a diverse set of ICUs that participated in the ICU Liberation Collaborative.

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