St. Mary’s Medical Center in Maine has had much success with its multidisciplinary discharge planning at the bedside. The TCAB unit aimed to strengthen team vitality and increase patient satisfaction by involving the entire care team as well as the patient in rounds and discharge planning. They collaborated with the chief hospitalist to develop a method for involving the patient and family in discharge planning. The care team includes the charge nurse, patient’s nurse, physician, case management, social worker, physical therapist or occupational therapist, and pastoral care...
Implementing medication safety zones has been shown to reduce medication errors and adverse drug events, thus increasing patient safety. The TCAB unit at Spectrum Health System–Gerber Memorial Hospital noted these findings and, using the Plan/Do/Study/Act cycle, created a “no interruption zone” in front of the medication preparation area. Nurses reported a calmer environment with fewer interruptions but suggested including the entire medication room due to logistics, physical environment, and continued interruptions from conversation outside of zoned areas. Through the...
Mercy Hospital Anderson’s Patient Family Council has heightened the TCAB team’s understanding of the patient experience, improved care, and increased patient satisfaction. The council meets once a month to engage in a roundtable discussion covering topics including issues of concern, recognition, TCAB successes, and patient satisfaction scores, among others. There are currently about 20 members, five of whom are either past patients or family members of patients. The remaining members consist of volunteers, leadership, and housekeeping. Membership has been increasing, most...
Since the implementation of TCAB at Medina Memorial Healthcare System, voluntary nurse turnover has improved markedly. Before TCAB, the average turnover rate was seven nurses per year. Over the course of 30 months of applying TCAB principles, only three nurses left, bringing the voluntary nurse turnover rate for 2011 down to 1.5 percent. The hospital attributes this difference to the collective involvement of frontline nurses in the improvement process and the effort by the nursing staff to engage newly hired nurses in TCAB. The chief nursing officer overseeing Medina’s TCAB unit...
The Gettysburg Hospital TCAB team applied a tried and true improvement tool, the Plan/Do/Study/Act (PDSA) process, to a problem identified on the TCAB unit. The team was spending too much time looking for equipment and supplies—“hunting and gathering.” They noticed a lack of organization and clutter that was impeding efficient care. To address this need to organize space, supplies, and equipment, the team went through the PDSA steps and used the principles of lean process referred to as the “5Ss: Making your space work for you.” The 5Ss stand for “sort...
It is estimated that 80,000 central venous catheter-associated nosocomial bloodstream infections occur annually in the United States.These infections have been shown in many instances to increase morbidity, length of hospital stay, and costs associated with hospital stay. In an effort to reduce these consequences, the TCAB team at Erie County Medical Center developed an innovation approach. Through education surrounding the negative effects of infection and the link to proper IV use, they increased IV tube labeling from 65 percent to 100 percent and thus reduced potential for infection on...
The 2012 AF4Q National Meeting was held in New Orleans, Louisiana form May 16-18. At the event the many successes of the Transforming Care at the Bedside or TCAB initiative was shared with the meeting attendees at a kiosk sharing this presentation. View the slidedeck here!
When the Minnesota Hospital Association (MHA) applied to join the Partnership for Patients (P4P) Hospital Engagement Network, it realized it would need to change the culture both at the leadership and front line staff levels to bring about the network’s required results.
Hospital Engagement Networks (HEN) work to develop learning collaboratives for hospitals and provide a wide array of initiatives and activities to improve...
The Lovelace Medical Center TCAB team dramatically improved the delivery of Pneumococcal vaccinations to hospitalized patients from 48% to 98%. Pneumococcal disease is the leading cause of vaccine preventable illness and death in the U.S. The vaccine is recommended that all people 65 years and older and persons with certain conditions and is so important that CMS requires hospitals to document that patients were screened and given the medication. The TCAB nurses identified that the process for screening patients was not standardized on the TCAB unit so they...
Over the past 18 months, Redington-Fairview General Hospital's TCAB Team made it their goal to improve their HCAHPS score for Nurse Responsiveness and patient satisfaction with Pain Control. After a national TCAB meeting where they learned about hourly rounding and the “Four P’s”, the team thought it made sense to try a strategy to meet the patients’ needs before they ask. The aide and the primary care nurse alternate rounding so that one or the other is in the patient’s room every hour. During the rounding process the patient is asked about pain,...