The Institute for Healthcare Improvement (IHI), in partnership with The Robert Wood Johnson Foundation (RWJF), has launched a comprehensive effort to improve care on hospital medical/surgical units.
Through an initiative called Transforming Care at the Bedside (TCAB), IHI and RWJF have created a framework for change on medical/surgical units built around improvements in four main categories:
- Safety and Reliability
- Care Team Vitality
- Increased Value
In 13 pilot hospitals, change ideas within each category are being tested, refined, and implemented, many with very promising early results. Examples include the 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; and redesigned workspace that enhances efficiency and reduces waste.
Many changes cannot be strictly categorized, but produce positive change in one or more categories.
IHI and RWJF believe that it is only by working in all four categories simultaneously that careteams can produce truly transforming results.
Transforming Care at the Bedside requires a commitment to changing the status quo. In this white paper report, IHI and RWJF offer hospitals a number of ideas to test, adapt, and implement as appropriate.