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The Road to Clinical Excellence:
BWH last week showcased its Bretholtz Center, newly renovated pods and successful patient-centered initiatives while hosting an 80-member delegation from the Institute for Healthcare Improvement's (IHI) Transforming Care at the Bedside (TCAB) program.
“Our colleagues came away impressed with how patient-centered BWH is,” said Barbara Bauman, RN, MSN, director of Surgical Nursing.
BWH is the sole New England hospital, and one of only 13 hospitals nationwide, selected by IHI to participate in the TCAB initiative funded by the Robert Wood Johnson Foundation. With many patient-centered programs in place in the Connors Center, the TCAB pilot program was launched last year on Orthopedic Surgery pods, Tower 16AB and 15CD.
As part of the national program, representatives from participating hospitals meet regularly to share efforts implemented in their own facilities.
In June, the IHI TCAB delegation met in Cambridge and toured BWH June 29. The TCAB delegation learned about eMAR, BWH Patient Family Liaison program, service excellence projects in Obstetrics and TCAB efforts launched in Orthopedics.
“It was a great visit,” said Susan Martin, RN, MSN, director of Nursing Performance at the University of Pittsburgh Medical Center (UPMC) Shadyside.
Martin said she left Francis Street with hopes of copying “daily touch points” now in place on 16AB and 15CD. “It's a five-minute management tool, and I plan on seeing how we can do it here,” Martin said.
Daily touch points allow clinicians to learn why a certain TCAB initiative, such as patient communication boards, may not have been carried out. “We could count and say 90 percent of patient communication boards were completed last week. But instead, we go to the staff and ask, 'What got in your way?'” said Bauman, who explained this method as more effective to system enhancements.
BWH considers “peace and quiet time” on the pods one of its most successful TCAB efforts, and that effort came from Martin's UPMC Shadyside. “We all 'steal' from each other,” said Martin.
Staff on 16AB and 15CD began with a brainstorming session for TCAB last year to create various prototypes and plans for implementation. In addition to peace and quiet time, other TCAB prototypes or experiments include the patient communication board, daily team huddle and “Dear Doctor” notes. These initiatives are aimed at improving the quality of patient care and customer service, making BWH care teams more efficient and effective, and improving staff satisfaction.
Plans are in place to roll out several TCAB initiatives to other floors and services this summer and fall. “We're refining and spreading these prototypes as we work on new ideas,” Bauman said.
Michael Gustafson, MD, MBA, vice president, Center for Clinical Excellence, said TCAB plays an important role in BWH's tripartite mission of patient care, research and education. “Some TCAB initiatives may seem like small steps at the bedside, but they afford us the opportunity to make significant strides toward clinical care excellence and improved patient satisfaction,” Gustafson said.