Yet, these healthcare providers may want to carefully consider why they’re not using the ventilator bundle—or at least parts of it, he says. Sometimes hospitals aren’t in the position to apply all of the components; they’re not practical. But if that’s the case, institutions or individuals who claim there are difficulties may very well want to look long and hard at those problems. “They should think about ways to change the landscape so they can apply these things,” says Dr. Kress. “We need to take the evidence we have and apply it in a careful, thoughtful way to individual patients, and see what happens, and then respond in a careful way. You can’t blindly follow a protocol. You have to modify the individual protocol depending on the circumstances. A protocol is not a mindless cookbook. It’s a starting point, a launch pad.” TH
Robin Tricoles is managing editor of the Journal of Hospital Medicine.