Tools for Transforming Care at the Bedside

This 14-page primer is a practical guide for nurses and other front-line health care staff to follow to apply the principles of Transforming Care at the Bedside (TCAB) in order to redesign work processes and improve patient care at their institution.

TCAB uses a four-step process for staff members to uncover opportunities to eliminate waste and enhance patient-centered care. This tool describes the following steps in detail:

  1. Plan-Use brainstorming sessions to unleash ideas then choose ones to work on.
  2. Do-Develop an idea by making it tangible and able to be communicated to others.
  3. Study-Test the idea in a small way and measure whether or not it works, refine it or incorporate other suggestions and feedback along the way.
  4. Act-Introduce the change on a larger scale and seek wider adoption of the change.

The Institute for Healthcare Improvement worked with the Robert Wood Johnson Foundation to develop the TCAB process, which seeks to create, test and implement changes that have the potential to dramatically improve care on hospital medical/surgical units, and enhance staff satisfaction. The American Organization of Nurse Executives created this tool, which is available online, to implement TCAB ideas more widely in hospitals across the nation.