| Primary Author: | Linda A. Roussel, DSN, RN, NEA-BC |
| Co-Principal Investigators/Collaborators: | Valorie Dearman, Ellen Buckner |
| Organization: | University of South Alabama College of Nursing |
Abstract
Background
Transforming care at the bedside (TCAB) is an evidence-based improvement process focused on safe, quality care by an engaged frontline staff. TCAB purports to close the gap between knowledge and practice through transforming knowledge and designating and implementing best practices. TCAB provides a framework facilitating frontline workers in tests of change, through such strategies as deep dives, huddles, and identified change champions. Sustaining and spreading TCAB continues a challenge.
Purpose
Determine the level of staff engagement and culture of safety and the impact of staff involved in transforming care at the bedside.
Materials & Methods
Immersed in the TCAB process through the American Organization of Nurse Executives and Robert Wood Johnson initiative, two hospital units in a tertiary health care system continued to track their process and progress using PDAs, nursing sensitive indicators, and tests of change interventions. The surgical trauma unit was the experimental unit, with a medical unit serving as the control. While both tracked data (nursing sensitive outcomes, direct care), only the experimental unit engaged in the TCAB processes with significant outcomes.
Results
Noted improvement from the TCAB unit in value-added nursing along with increased time in direct care. Reduced overtime was also noted. Patients’ satisfaction with pain management using pain boards, bedside report and hourly rounding were also noted to improve the process of care delivery.
Conclusion
TCAB as improvement science does offer a method of enhancing staff engagement end improved patient care. Sustaining improvement and spreading best practices are ongoing challenges within the system.
© Improvement Science Research Network, 2011