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Evidence-Based Nursing: Taking care of business with TCAB
Mary DeLima BA, BSN, RN-BC
Nancy Holecek MHA, BSN, RN
Jennifer A. O'Neill RNFA, APN-C

$3.95 		Nursing Management
December 2011 
Volume 42  Number 12
Pages 19 - 22
 
  PDF Version Available!

ABSTRACT
Transforming Care at the Bedside (TCAB) has become a national movement to improve the quality and safety of patient care on medical-surgical units while simultaneously transforming the culture of how nurses care for patients. When TCAB processes take over, the results are nursing innovation, vitality, increased patient satisfaction, and direct care nurses at the bedside who feel empowered to make a difference in the lives of patients.Barnabas Health (formerly Saint Barnabas Health Care System), with more than 18,200 employees who provide treatment for more than 2 million patients annually, has adopted the TCAB initiative on 14 nursing units throughout its six hospitals. Our experience has shown that not only have the units sustained significant quality improvement outcomes, but the opportunities for nursing empowerment and leadership have also been transformative. Nursing units have embraced the framework for TCAB, which has inspired and energized the staff.TCAB was a multiphase initiative, originally started in 2003 by a collaboration between the Institute for Healthcare Improvement and the Robert Wood Johnson Foundation (RWJF). It began with a three-hospital pilot that expanded to 13 hospitals.1 Since 2007, the project has been disseminated to over 67 hospitals across the country through the American Organization of Nurse Execu-tives (AONE). The goal of the initiative was to "restore the vitality of the nursing staff, reduce inefficiencies in care and improve outcomes for patients."2 The architects of the initiative believed that medical-surgical units needed to undergo a redesign and that this transformation should start at the bedside. TCAB was the way to "develop and share practical, easy-to-use tools to redesign care processes and improve patient care."3 TCAB was also seen as a way to empower nurses while enabling them to spend more time on direct patient care.4A 42-bed pulmonary unit at Saint Barnabas Medical Center in Livingston, N.J., was selected as the pilot.

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