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transforming care at the bedside

Frederic Ehrler, Katherine Blondon, Dominique Baillon-Bigotte, Christian Lovis
Although mobile devices become more and more common in clinicians' hands, transforming them into an institutional tool to access electronic health record information at the patient's bedside still raises many questions. One of these questions is the provenance of mobile devices when these are deployed at an institutional level. Some advocate the use of personal devices, known as BYOD, for its lower cost, others favor the use of institutional devices which allow a standardization of the development, deployment and support processes...
2017: Studies in Health Technology and Informatics
Donna M Glynn, Cecilia McVey, Judith Wendt, Bonnie Russell
Over the past decade, health care leaders have called for a radical transformation in health care and nursing education. Patient care has become complex, demanding succinct interprofessional communication and collaboration to optimize the care of the patient, and the nurse at the bedside is the optimal leader at the point of care. Assistance with the clinical reasoning and critical thinking with nursing students is pivotal for successful patient outcomes. The expert clinical nurse at the bedside is the premier faculty to guide the young practitioner in the care of the patient...
March 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
Andrew S Dunn, Maria Reyna, Brian Radbill, Michael Parides, Claudia Colgan, Tobi Osio, Ari Benson, Nicole Brown, Joy Cambe, Margo Zwerling, Natalia Egorova, Harold Kaplan
BACKGROUND: Communication among team members within hospitals is typically fragmented. Bedside interdisciplinary rounds (IDR) have the potential to improve communication and outcomes through enhanced structure and patient engagement. OBJECTIVE: To decrease length of stay (LOS) and complications through the transformation of daily IDR to a bedside model. DESIGN: Controlled trial. SETTING: 2 geographic areas of a medical unit using a clinical microsystem structure...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Mélanie Lavoie-Tremblay, Patricia O'Connor, Alain Biron, Geneviéve L Lavigne, Julie Fréchette, Anaïck Briand
The objective of the study was to document the impact of Transforming Care at the Bedside (TCAB) program on health care team's effectiveness, patient safety, and patient experience. A pretest and posttest (team effectiveness) and a time-series study design (patient experience and safety) were used. The intervention (the TCAB program) was implemented in 8 units in a multihospital academic health science center in Montreal, Quebec, Canada. The impact of TCAB interventions was measured using the Team Effectiveness (TCAB teams, n = 50), and Clostridium difficile-associated diarrhea and vancomycin-resistant Enterobacter rates (patient safety) and Hospital Consumer Assessment of Healthcare Providers and Systems (patient experience; n = 551 patients)...
January 2017: Health Care Manager
Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Alison M Aldrich, Daniel M Walker, Milisa K Rizer, Susan D Moffatt-Bruce, Timothy R Huerta
BACKGROUND: For patients with complex care needs, engagement in disease management activities is critical. Chronic illnesses touch almost every person in the United States. The costs are real, personal, and pervasive. In response, patients often seek tools to help them manage their health. Patient portals, personal health records tethered to an electronic health record, show promise as tools that patients value and that can improve health. Although patient portals currently focus on the outpatient experience, the Ohio State University Wexner Medical Center (OSUWMC) has deployed a portal designed specifically for the inpatient experience that is connected to the ambulatory patient portal available after discharge...
November 29, 2016: JMIR Research Protocols
Isabell B Purdy, Mary Alice Melwak, Joan R Smith, Carole Kenner, Rebecca Chuffo-Siewert, Donna J Ryan, Pamela A Geller, 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...
February 2017: 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...
November 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...
October 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)...
November 2016: 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
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