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Facilitating Nurses' Engagement in Hospital Quality Improvement: The New Jersey Hospital Association's Implementation of Transforming Care at the Bedside

Pearson, Marjorie L.; Needleman, Jack; Beckman, Robin; Han, Bing

The Journal for Healthcare Quality (JHQ): November/December 2016 - Volume 38 - Issue 6 - p e64–e75
doi: 10.1097/JHQ.0000000000000007
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Abstract: Transforming Care at the Bedside (TCAB) is a program designed by the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement to engage frontline staff in change processes to improve the work environment and patient care on nursing units. Originally designed and piloted in a small number of hospitals, TCAB is being disseminated through large-scale quality improvement (QI) collaboratives facilitated by professional organizations, such the New Jersey Hospital Association's Institute for Quality and Patient Safety (NJHA). This article presents the results of an evaluation of the NJHA dissemination effort. The evaluation team used an observational mixed-method evaluation design and multiple data sources to assess implementation of TCAB by nursing units in these facilities. The results show that most of the participating units successfully implemented the TCAB improvement processes. Nursing teamwork and three nursing-sensitive outcomes improved significantly over the course of TCAB, and TCAB unit managers attributed important improvements to their unit's participation. These findings suggest that TCAB is a viable mechanism for engaging frontline nursing staff in valuable QI activities. Other hospitals interested in furthering the culture and capacity for QI among frontline nursing unit staff should consider a TCAB collaborative for achieving these goals.

Supplemental Digital Content is Available in the Text.

For more information on this article, contact Marjorie L. Pearson at mpearson@rand.org.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and in the HTML and PDF versions of the article atwww.jhqonline.com.

The authors declare no conflicts of interest.

© 2016 National Association for Healthcare Quality
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