The Business Case for TCAB

Estimates of Cost Savings with Sustained Improvement

Implementing Transforming Care at the Bedside (TCAB), a nurse-led quality initiative which aims to create rapid improvement, resulted in large gains in outcomes and large savings in costs, according to two executives with Cedars-Sinai Medical Center in Los Angeles, one of the hospitals participating in the TCAB pilot program. Appearing in a special supplement of the American Journal of Nursing, this analysis focuses on the rates of nursing turnover, patient falls and hospital-acquired pressure ulcers as indicators of the program’s success and finds all three measures improved significantly during the 2004-2008 pilot program. The related savings are estimated to be in the tens of millions of dollars. By comparison, the hospital estimates its cost to initially create an infrastructure to implement TCAB was $500,000 and its ongoing annual infrastructure cost is about $50,000.