Formerly known as a Learning and Innovation Community, the Transforming Care at the Bedside Collaborative will build on the work of the Community and continue testing ideas and implementing changes that lead to lasting improvements in care at the bedside. 

 Listen to the July 28 informational call, led by faculty, regarding IHI’s upcoming Collaboratives. Review the presentation slides. Please note due to technical difficulties, the first two minutes of the call were not recorded. At this time, a general program description was presented.

The Challenge
The Institute of Medicine’s report, To Err Is Human, documented wide-scale quality problems in the nation’s health care system, including up to 98,000 hospital patient deaths each year due to medical errors. Since this landmark report was released, many organizations have launched initiatives to redesign care, but few have focused on the backbone of hospital care — medical and surgical units — areas where most patients receive care during a typical hospital stay. 

The challenge of providing safe, reliable, efficient, timely, and patient-centered care in medical and surgical units is compounded by increasing acuity levels of patients, shorter patient stays, and increasing technological complexity. Adding to these stressors is an ever-expanding range of new therapies for clinicians to incorporate into their practices, increasing diversity of the patient population, and mounting paperwork. In many hospitals the work environment on medical and surgical units is chaotic and inefficient, contributing to high nursing turnover rates.

The Solution
Hospitals cannot meet the current challenges on medical and surgical units by fine-tuning the status quo or exhorting staff to work more diligently — they must establish new models of care. In such a demanding and fast-changing care setting, effective inter-professional teamwork and collaboration are of utmost importance for the transformation of bedside care on medical and surgical units. Promising new models for transforming care on medical and surgical units have emerged through a collaboration of the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI), called Transforming Care at the Bedside, which formed the basis for this Collaborative. 

Launched in 2003, Transforming Care at the Bedside (TCAB), a national program of RWJF and IHI, engaged 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 

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 to develop innovations and exemplary care models on medical and surgical units to dramatically improve outcomes for patients and staff alike. Currently, hundreds of hospitals across the US and internationally are implementing TCAB strategies and changes on medical and surgical units.