Field of Work: Nurse workforce development and patient care improvement

Problem Synopsis: The quality of nursing care has a direct impact on the quality and safety of the care that hospital patients receive. Too often inefficient workplace policies and practices and a chaotic environment prevent hospital nurses from focusing fully on the needs of their patients. Both patient care and nurse job satisfaction suffer as a result.

Synopsis of the Work: In September 2009 the New Jersey Hospital Association launched a three-year program to empower front-line hospital nurses to implement innovative practices aimed at improving the hospital work environment and the quality of patient care.

Entitled Transforming Care at the Bedside-New Jersey, the program is a state-specific application of a staff-driven, bottom-up approach to hospital improvement developed by the Institute for Healthcare Improvement in partnership with the Robert Wood Johnson Foundation (RWJF). Two-thirds of the state’s acute care hospitals participated.

Key Results to Date: The program is now at the halfway point, and there are so far no quantitative measures of TCAB’s impact on the participating organizations. From their vantage point, the hospital association’s program leadership sees a range of effort and impact across the 51 sites.

Anecdotal evidence suggests that in organizations with a high level of support and enthusiasm for the TCAB approach, TCAB is making a positive difference in workplace practices and environment and in staff engagement. The report describes several specific changes made by participants.