Transforming Care at the Bedside

[NRSKarenRN, BSN, RN]

with so much care being delivered in hospital medical/surgical units, and with an estimated 35 to 40 percent of unexpected hospital deaths occurring on such units, the robert wood johnson foundation (rwjf) and ihi agreed to work together to create, test, and implement changes that will dramatically improve care on medical/surgical units, and improve staff satisfaction as well.

in 2003, through an initiative called transforming care at the bedside (tcab), rwjf and ihi created a framework for change on medical/surgical units built around improvements in four main categories:

• safe and reliable care
  
• vitality and teamwork
  
• patient-centered care
  
• value-added care processes

in 13 pilot hospitals, change ideas within each category are being tested, refined, and implemented, many with very promising early results. examples include the following:

• use of rapid response teams to “rescue” patients before a crisis occurs
  
• specific communication models that support consistent and clear communication among caregivers
  
• professional support programs such as preceptorships and educational opportunities
  
• liberalized diet plans and meal schedules for patients
  
• redesigned workspace that enhances efficiency and reduces waste

http://www.ihi.org/ihi/programs/strategicinitiatives/transformingcareatthebedside.htm

fourteen new partnerships announced for

transforming care at the bedside

transforming care at the bedside, a collaborative effort of the institute for healthcare improvement (ihi), the robert wood johnson foundation (rwjf) and 13 u.s. hospitals across the country has been featured in previous articles published in reflections on nursing leadership (“coming: to a hospital near you,” fourth qtr. 2005, and “putting nurses in the driver’s seat,” second qtr. 2006).

now, 14 new strategic partnerships between schools of nursing and major regional hospitals throughout the united states have been announced for the program. the partnerships will help future nurses learn how to identify opportunities for quality improvements that could enhance patient care, and teach them how to advocate for their implementation. nursing students will work with tcab teams at their partner hospitals to identify where change is needed, recommend and test potential solutions and determine if the innovations should be implemented. in so doing, the program provides a vital link between the classroom and the medical-surgical units in hospitals by helping nursing students understand how the time they spend working directly with patients affects the quality of care patients receive.

http://nursingsociety.org/rnl/current/departments/rnews_capsules.html

[pickledpepperRN]

Sorry but pretty charts and political wins regarding terminology don't save lives or comfort patients. Nurses do that.

Until they START with safe staffing I am no longer interested in "Patient Focused Care", "Health care’s shifting paradigms", “Putting nurses in the driver’s seat”, "strategic partnerships", or other such "innovations".

[YooperNurse]

My! What a lot of --well, to be nice--- hoo haa. Are they going to try to teach student nurses at the get go to work short staffed and like it? Is that what this is about? Until everyone realizes that all you need is adequate staffing levels for what your acuity is, it's all going to be smoke and mirrors to save money.

[BULLYDAWGRN, RN]

What a bunch of balony.. Fancy words from a bunch of bean counting nurses don't mean jack. The real issue (as far as my state) is safe pt to staff ratios. And no one in my state has championed this.. Not even our bon, if they have no one knows about it. If the usa today or some big news paper or times just interviewed your average run of the mill nurse who actually takes care of the pt's and not interview some behind the desk "bean countin" nurse or some research/education person, the public would know what nurses want. But they never ask the workin nurse nothin.

[OzMW]

I'm in Australia and I am a midwife/RN in a maternity unit. This stuff is about to be thrust upon us! Anyone worked with it? It is so typically being introduced by the bureaucrats! Seems like a crock..................

[Simplepleasures]

We have had these types of new wonderful innovative ways of nursing introduced before, but they never could get off the ground while the REAL nurse was running her butt off and pulling her hair out in frustration.

[anonymurse]

Funny word, bedside. Maybe when the word "bedside" appears in a project title, it indicates that those who got the grant want to control those at the bedside, but don't want to be there themselves. Those at bedside don't use the word "bedside." What's with all this obsessing with being at the bedside like it was an exotic remote country? Docs don't think there's anything wrong with bedside doctoring. What should I pay a mechanic who won't work carside? I need a hefty grant to research all this!

[OzMW]

Funny word, bedside. Maybe when the word "bedside" appears in a project title, it indicates that those who got the grant want to control those at the bedside, but don't want to be there themselves. Those at bedside don't use the word "bedside." What's with all this obsessing with being at the bedside like it was an exotic remote country? Docs don't think there's anything wrong with bedside doctoring. What should I pay a mechanic who won't work carside? I need a hefty grant to research all this!

Interestingly these are the things that make me wonder WHY this is appropriate to maternity care. Women are mostly well and one could argue that they should even be referred to as "patients" at all. Amuses the crap outta me:uhoh3::uhoh3: