Where’s the Nurse’s Focus?

“We have to take this next step. We have to do this because it will improve our care, and reduce the waste,” stated Kris OShea, Chief Nursing Officer and Vice President of Patient Care for Gettysburg Hospital, and Clinical Transformation Officer for WellSpan Health.

Kris is referring to the initiative, Transforming Care at the Bedside, also known as TCAB. TCAB is an initiative of the Robert Wood Johnson Foundation and Institute for Healthcare Improvement (IHI).  AF4Q – South Central PA is working with York and Gettysburg Hospitals to implement this initiative in their medical and surgical units.

By using TCAB, the hospitals are aiming to improve the quality of patient care and patient service, provide more effective care teams, improve staff satisfaction and retention, and be more efficient at the bedside in medical and surgical units. With these goals in mind, the participants of Transforming Care at the Bedside are focusing on improvements in five categories: safe and reliable care, vitality and teamwork, transformational leadership, patient-centered care and value-added care processes.

One of the techniques that Gettysburg Hospital’s nurses have implemented is bedside reporting. Instead of discussing the patient’s health outside of the room, the nurses coming on and going off their shift, talk about the patient’s status in front of the patient. This helps start the nurse-patient relationship, and allows the patient and family to witness the teamwork. It results in having a more confident patient and family, and provides the patient the ability to be engaged in their care.

Similar to the other AF4Q collaboratives, the nursing staff has been encouraged to start small, as it takes testing, refining and implementing change ideas. “It’s a process, and it will take tweaking. We start with one patient, one nurse. That one nurse pulls in another nurse to do bedside reporting, and then from there each nurse sees what worked and what didn’t – and then it’s recorded, reported to the collaborative, and tweaked to try again,” stated OShea.

As part of the collaborative, the hospitals meet with a local team of coaches, as well as other Aligning Forces for Quality communities across the nation to discuss the outcomes, issues and benefits of their techniques.

Overall, the small changes are being implemented, and it’s making an impact on both the patient and staff in a positive way.

“Just by redesigning the workspace, we’re enhancing efficiency and reducing waste. Throughout this process, we’ve also noticed that the nurses are holding each other accountable. And, that is showing us that the nurses are more engaged, which then translates to the patient feeling better,” said OShea.

To learn more about Transforming Care at the Bedside, contact Chris Amy, Project Director for Aligning Forces for Quality – South Central PA at (717) 801-4823.

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