Author Affiliations: Department of Surgery, University of California, San Francisco (Dr Hunt), and Departments of Anesthesiology and Bioengineering, University of Utah School of Medicine, Salt Lake City (Dr Hopf).
The idea of studying bundles is a worthy one, and Anthony et al1 are to be congratulated for attempting it. An evidence-based practice bundle reflects the reality that multiple protocols intended to improve patient outcome have been identified, and there is pressure to implement them all at once. The challenge of studying a specific bundle of interventions to prevent surgical site infection, however, is putting together a bundle that is both evidence-based and feasible within an institution's culture and prevailing practice.
Hunt TK, Hopf HW. Selection of Bundle Components. Arch Surg. 2011;146(10):1220-1221. doi:10.1001/archsurg.2011.249