Unpacking the Bundle to Lower Rates of Ventilation-Associated Pneumonia: Parts May Be Less Than the Sum

The concept of a bundle as a way to implement multiple best practices together to support quality improvement and better patient outcomes has great appeal.^1,2 However, little is known about how bundles work and whether the individual components or the group are most important to care improvement. In this issue of JAMA Internal Medicine, Klompas and colleagues³ demonstrate that individual components of a bundle to lower rates of ventilator-associated pneumonia may have different effects on the outcome.