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transforming care at the bedside

Isabell B Purdy, Mary Alice Melwak, Joan R Smith, Carole Kenner, Rebecca Chuffo-Siewert, Donna J Ryan, Sue Hall
BACKGROUND: The neonatal intensive care unit (NICU) can be a stressful environment for infants, their families, and the healthcare team. There is an immediate need for neonatal nurses to embrace and translate the new National Perinatal Association recommendations for psychosocial support of NICU parents into clinical practice to demonstrate best practices for infants, their families, and the whole team. PURPOSE: To summarize the current evidence-based practice recommendations and to provide suggestions for team members to develop strategies to adopt and implement them through quality improvement (QI) projects...
October 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Joyce J Fitzpatrick, Mary Beth Modic, Jennifer Van Dyk, K Kelly Hancock
OBJECTIVE: The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders. BACKGROUND: The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management...
October 12, 2016: Journal of Nursing Administration
Mélanie Lavoie-Tremblay, Patricia O'Connor, Alain Biron, Brenda MacGibbon, Guylaine Cyr, Julie Fréchette
This article presents the experiences of patients engaged in co-designing care under a program entitled, "Transforming Care at the Bedside," based at an academic health sciences center. This descriptive, qualitative study collected data through individual interviews. Participants included patients from 5 units in an academic health sciences center in Quebec, Canada. A total of 6 individual interviews were conducted in November 2014, 15 months after the Transforming Care at the Bedside work began in September 2013...
September 26, 2016: Health Care Manager
Cynda Hylton Rushton
Undisputedly, the United States' health care system is in the midst of unprecedented complexity and transformation. In 2014 alone there were well over thirty-five million admissions to hospitals in the nation, indicating that there was an extraordinary number of very sick and frail people requiring highly skilled clinicians to manage and coordinate their complex care across multiple care settings. Medical advances give us the ability to send patients home more efficiently than ever before and simultaneously create ethical questions about the balance of benefits and burdens associated with these advances...
September 2016: Hastings Center Report
Jed D Gonzalo, Judy Himes, Brian McGillen, Vicki Shifflet, Erik Lehman
BACKGROUND: Interprofessional collaboration improves the quality of medical care, but integration into inpatient workflow has been limited. Identification of systems-based factors promoting or diminishing bedside interprofessional rounds (BIR), one method of interprofessional collaboration, is critical for potential improvements in collaboration in hospital settings. The objective of this study was to determine whether the percentage of bedside interprofessional rounds in 18 hospital-based clinical units is attributable to spatial, staffing, patient, or nursing perception characteristics...
2016: BMC Health Services Research
Angela Morin
Patient-centred care and patient engagement are not the "flavour of the month" nor just buzz phrases. The role of the patient voice in the review of the Quality of Care Information Protection Act and the creation of the Health Information Protection Act 2016 (Bill 119) was significant and transformative. Engaging patients and families whether at the bedside in a hospital, at the decision-making table in a healthcare organization, or in the creation of policy at the provincial and national levels is changing our healthcare system...
September 2016: Healthcare Management Forum
Joseph S Fernandez-Moure
The evolution of medicine and medical technology hinges on the successful translation of basic science research from the bench to clinical implementation at the bedside. Out of the increasing need to facilitate the transfer of scientific knowledge to patients, translational research has emerged. Significant leaps in improving global health, such as antibiotics, vaccinations, and cancer therapies, have all seen successes under this paradigm, yet today, it has become increasingly difficult to realize this ideal scenario...
2016: Frontiers in Bioengineering and Biotechnology
(no author information available yet)
JUNE JOLLY, who has died at the age of 87, was an influential nurse and author who helped transform the care of children in hospital. She overturned the tradition that excluded parents from their child's bedside. She also, famously, brought a baby elephant and a lion cub into St Thomas' Hospital to delight children and, as nursing officer in paediatrics at the Brook Hospital in Woolwich, London, persuaded a circus to entertain on site - dressing as a clown herself.
May 9, 2016: Nursing Children and Young People
Jack Needleman, Marjorie L Pearson, Valda V Upenieks, Tracy Yee, Joelle Wolstein, Melissa Parkerton
BACKGROUND: Process improvement stresses the importance of engaging frontline staff in implementing new processes and methods. Yet questions remain on how to incorporate these activities into the workday of hospital staff or how to create and maintain its commitment. In a 15-month American Organization of Nurse Executives collaborative involving frontline medical/surgical staff from 67 hospitals, Transforming Care at the Bedside (TCAB) was evaluated to assess whether participating units successfully implemented recommended change processes, engaged staff, implemented innovations, and generated support from hospital leadership and staff...
February 2016: Joint Commission Journal on Quality and Patient Safety
Marjorie L Pearson, Jack Needleman, Robin Beckman, Bing Han
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)...
September 7, 2015: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
S M Alexander, A Nerminathan, A Harrison, M Phelps, K M Scott
mHealth is transforming health care, yet few studies have evaluated patient and carer perceptions of the use of smartphones at the patient bedside. In this study, 70 patients and carers answered a short survey on health professionals' use of mobile devices. Half the participants were tolerant of doctors using such devices if it was work-related; others believed it was a distraction and not beneficial to patient care. Changes in practice and patient education may be needed to enable effective use of mobile devices in health...
November 2015: Internal Medicine Journal
Alvin S Calderon, C Craig Blackmore, Barbara L Williams, Kavita P Chawla, Dana L Nelson-Peterson, Michael D Ingraham, Donna L Smith, Gary S Kaplan
BACKGROUND: Traditional "batched" bedside clinical care rounds, where rounds for all patients precede clinical tasks, may delay clinical care and reduce resident work efficiency. INNOVATION: Using Lean concepts, we developed a novel "Rounding-in-Flow" approach, with the patient care team completing all tasks for a single patient before initiating any tasks for the next patient. Outcome measures included timely patient discharge and intern work hours. METHODS: We performed a retrospective cohort study with historic and contemporaneous control groups, with time series adjustment for underlying temporal trends at a single medical center...
December 2014: Journal of Graduate Medical Education
Jeph Herrin, Kathleen G Harris, Kevin Kenward, Stephen Hines, Maulik S Joshi, Dominick L Frosch
BACKGROUND: Patient and family engagement (PFE) in healthcare is an important element of the transforming healthcare system; however, the prevalence of various PFE practices in the USA is not known. OBJECTIVE: We report on a survey of hospitals in the USA regarding their PFE practices during 2013-2014. RESULTS: The response rate was 42%, with 1457 acute care hospitals completing the survey. We constructed 25 items to summarise the responses regarding key practices, which fell into three broad categories: (1) organisational practices, (2) bedside practices and (3) access to information and shared decision-making...
March 2016: BMJ Quality & Safety
Mélanie Lavoie-Tremblay, Patricia O'Connor, Geneviève L Lavigne, Anaïck Briand, Alain Biron, Sophie Baillargeon, Brenda MacGibbon, Justin Ringer, Guylaine Cyr
PURPOSE: The purpose of this study was to describe how spread strategies facilitate the successful implementation of the Transforming Care at the Bedside (TCAB) program and their impact on healthcare workers and patients in a major Canadian healthcare organization. DESIGN: This study used a qualitative and descriptive design with focus groups and individual interviews held in May 2014. Participants included managers and healthcare providers from eight TCAB units in a university health center in Quebec, Canada...
July 2015: Journal of Nursing Scholarship
Deborah A Devine, Barb Wenger, Mary Krugman, Jennifer E Zwink, Kaycee Shiskowsky, Jan Hagman, Shelly Limon, Carolyn Sanders, Catherine Reeves
An academic hospital used Transforming Care at the Bedside (TCAB) principles as the framework for generating evidence-based recommendations for the design of an expansion of the current hospital. The interdisciplinary team used the table of evidence-based data to advocate for a patient- and family-centered, safe, and positive work environment. A nurse project manager acted as liaison between the TCAB design team, architects, and facilities and design consultants. Part 2 of this series describes project evaluation outcomes...
February 2015: Journal of Nursing Administration
Kevin W McEnery
For the practice of radiology, the transition to filmless imaging operations has resulted in a fundamental transition to more efficient clinical operations. In addition, the electronic delivery of diagnostic studies to the bedside has had a great impact on the care process throughout the health care enterprise. The radiology information system (RIS) has been at the core of the transition to filmless patient care. In a similar manner, the electronic medical record (EMR) is fundamentally and rapidly transforming the clinical enterprise into paperless/digital coordination of care...
December 2014: Journal of the American College of Radiology: JACR
Mélanie Lavoie-Tremblay, Patricia O'Connor, Geneviève L Lavigne, Alain Biron, Justin Ringer, Sophie Baillargeon, Brenda MacGibbon, Guylaine Cyr, Anaïck Briand
BACKGROUND: The Transforming Care at the Bedside (TCAB) project engages frontline health care providers as the leaders of change and improvement efforts in their work environment. This study explored how health care providers and managers from three TCAB units in a university-affiliated health care center perceived the development of their change capacities following their involvement in this program. METHOD: This descriptive, qualitative study involved focus groups and individual interviews...
November 2014: Journal of Continuing Education in Nursing
Patrice Lindsay, Karen L Furie, Stephen M Davis, Geoffrey A Donnan, Bo Norrving
Every two seconds, someone across the globe suffers a symptomatic stroke. 'Silent' cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention, acute stroke management, and stroke recovery...
October 2014: International Journal of Stroke: Official Journal of the International Stroke Society
Stephen A Boppart, Rebecca Richards-Kortum
Leveraging advances in consumer electronics and wireless telecommunications, low-cost, portable optical imaging devices have the potential to improve screening and detection of disease at the point of care in primary health care settings in both low- and high-resource countries. Similarly, real-time optical imaging technologies can improve diagnosis and treatment at the point of procedure by circumventing the need for biopsy and analysis by expert pathologists, who are scarce in developing countries. Although many optical imaging technologies have been translated from bench to bedside, industry support is needed to commercialize and broadly disseminate these from the patient level to the population level to transform the standard of care...
September 10, 2014: Science Translational Medicine
Chantelle Rizan, Christopher Elsey, Thomas Lemon, Andrew Grant, Lynn V Monrouxe
CONTEXT: Feedback associated with teaching activities is often synonymous with reflection on action, which comprises the evaluative assessment of performance out of its original context. Feedback in action (as correction during clinical encounters) is an underexplored, complementary resource facilitating students' understanding and learning. OBJECTIVES: The purpose of this study was to explore the interactional patterns and correction modalities utilised in feedback sequences between doctors and students within general practice-based bedside teaching encounters (BTEs)...
September 2014: Medical Education
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