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Lessons from an incomplete implementation project introducing the AMBER care bundle


The AMBER care bundle was formally adopted in 2015 by the National Health Service (NHS) Improving Quality and provides a systematic approach to managing the care of hospital patients who are facing an uncertain recovery and who are at risk of dying in the next 1–2 months. This paper describes the introduction of this approach in an acute hospital and analyses why the implementation remained incomplete. The normalisation process theory (NPT) is used as the conceptual framework to understand the complex processes involved, the importance of context and sense-making. Key learning points from the incomplete adoption of the AMBER care bundle are outlined. We conclude that the NPT is helpful in monitoring progress and allow for timely adaptation to ensure successful implementation. We suggest that its use as a diagnostic tool might be explored.

  • Amber care bundle
  • implementation
  • complex intervention
  • Normalisation Process Theory

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