Field of Work: Improving hospital patient care and the hospital work environment

Problem Synopsis: Nurses are the largest group of health care professionals providing direct patient care in hospitals, and their performance has a significant impact on patient safety and the overall patient experience. In a 2003 report, the Institute of Medicine underlined the critical link between quality of care and quality of nursing. The report called for fundamental redesign of how nurses work and the culture in which they work.

Synopsis of the Work: Developed by the Robert Wood Johnson Foundation (RWJF) in collaboration with the Institute for Healthcare Improvement (IHI), Transforming Care at the Bedside (TCAB) sought to empower front-line nurses to implement innovative new practices on their units. It emphasized a bottom-up approach to change. The goal was not only to make the hospital experience safer and more pleasant for patients but also to free up nurses to spend more time in direct patient care, thereby increasing nurse job satisfaction and retention as well as quality of care.

The TCAB program developed, tested and disseminated a structured process for empowering nurses and other front-line hospital staff to take the lead in improving the work environment and quality of patient care on medical-surgical units.