The Robert Wood Johnson Foundation has selected 16 hospitals to participate in the first two cohorts of a collaborative project engaging nurses and other frontline staff to improve the quality of patient care on medical and surgical units in hospitals.
The "Aligning Forces for Quality: Transforming Care at the Bedside Collaborative," or TCAB, is part of the Aligning Forces for Quality initiative, a cornerstone of the Foundation's $300-million financial commitment to improving U.S. healthcare quality.
John R. Lumpkin, MD, senior vice president and director of the healthcare group at the Robert Wood Johnson Foundation, said hospitals from 14 communities applied to be part of the TCAB Collaborative. The collaborative is based on TCAB programs launched by the RWJF and the Institute for Healthcare Improvement in 2003.
According to Lumpkin, hospitals that have already participated in TCAB report a cultural shift on their medical-surgical units that has produced better clinical outcomes, more time spent with patients, reduced nurse turnover and lower costs.
RWJF officials claim that TCAB is not a traditional quality improvement program because of its primary focus on engaging nurses and other frontline staff to develop and lead the quality improvement efforts.
Ideas for transforming care come from those who spend the most time providing direct care to patients, not from the hospital's executive suite or quality improvement staff. Nurse-led teams identify where change is needed on their unit, suggest and test potential solutions, and decide whether and how those innovations should be implemented.
"Empowering frontline staff - particularly nurses - to improve the processes of care delivery is one of the key features of the TCAB Collaborative," said Lumpkin. "Since nurses work closest to the patient, they have the unique opportunity to best identify how to make things work better."
Lumpkin said the TCAB Collaborative will be overseen by the Center for Health Care Quality at The George Washington University Medical Center School of Public Health and Health Services. The American Organization of Nurse Executives will provide technical assistance, and the Institute for Healthcare Improvement will convene training workshops for participants.
The first hospital cohort will kick-off this month and the second cohort launches in the fall of 2009.
Participating hospitals in the two cohorts are:
Cohort I
Mt. Clemens Regional Medical Center (Detroit)
Redington-Fairview General Hospital (Maine)
St. Mary's Regional Medical Center (Maine)
Webber Hospital Association (Southern Maine Medical Center)
St. Francis Hospital (Puget Sound, Wash.)
Erie County (N.Y.) Medical Center Corporation
Medina (N.Y.) Memorial Health Care System
Cohort II
Mercy Hospital Anderson (Cincinnati, Ohio)
Garden City Hospital, (Detroit)
Sinai-Grace Hospital, (Detroit)
Eastern Maine Medical Center
Saint Francis Hospital Memphis (Tenn.)
MultiCare Health System - Tacoma (Wash.) General Hospital
Gettysburg (Penn.) Hospital
York (Penn.) Hospital
Newaygo County General Hospital Association (Mich.)