TCAB's History and Results

First launched as a pilot project in 2003, Transforming Care at the Bedside (TCAB) is a national program that was developed and managed by the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI). Its goal is to engage front-line hospital nurses and leaders at all levels of the organization to:

  • improve the quality and safety of patient care on medical and surgical units
  • increase the vitality and retention of nurses
  • engage and improve the patient's and family members' experience of care
  • improve the effectiveness of the entire care team.

Ten hospitals participated in phase III of the program to test new concepts, develop exemplary care models on medical/surgical units and demonstrate institutional commitment and resources to support and sustain these innovations. In addition, scores of hospitals across the country and internationally are now applying TCAB principles and processes in their work.

TCAB developed models of care at the bedside on medical and surgical units that resulted in:

  • improved quality of patient care
  • more effective care teams
  • improved staff satisfaction and retention
  • greater efficiency.

TCAB is not a traditional quality improvement program. One primary characteristic that sets it apart is its focus on engaging front-line staff and unit managers. Ideas for transforming the way care is delivered on medical/surgical units come not from the executive suite or a quality improvement department, but from the nurses and other care team members who spend the most time with patients and their families. These teams identify where change is needed, suggest and test potential solutions and decide whether those innovations should be implemented.