What's Involved in TCAB

    • June 4, 2008

A Simple List For Hospitals Who Want to Begin Transforming Care at the Bedside:

  • Support from hospital leadership—a commitment from hospital executives, clinical directors and clinical managers—to support a nurse-led quality improvement program.
  • A unit in the hospital with strong interest in participating in TCAB.
  • Reliable, enthusiastic and motivated team leader (a nurse leader that others look up to).
  • Team members—at least five people, with appropriate interdisciplinary staff representation.
  • Facility announcement on program participation and unit selection… (e.g., “kickoff informational staff meeting for each shift working on TCAB unit”).
  • Introductory team meeting with entire TCAB team.
  • Create awareness for hospital's TCAB effort (e.g., post visuals in unit: “Welcome to TCAB Unit;” colored chart of TCAB Framework, etc.).
  • Plan "deep dive" and "snorkel" exercises—include ancillary unit staff, physicians in activities (can also include patients, families and students).

    • Hold a brainstorm to develop ideas for improvement.
  • Prioritize areas of focus for potential interventions resulting from brainstorm. (Things to consider: cost, resources needed and time investment).
  • Select a process for immediate improvement, design a test for an improved process, and test it.

    • Establish baseline measures for the test and determine how to collect data.
  • Schedule weekly updates with team members.

    • Outline issues, actions and next steps to update weekly and share with TCAB team.
  • Convene weekly meetings with frontline staff on the unit to explain tests of change.
  • Conduct at least one test of change three days a week.
  • Analyze data.
  • Determine if test of change should be adapted, adopted or abandoned.
  • Recognize staff for even the smallest of successes.
  • Share successes with leadership.
  • Spread successful tests of change to other units.

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