Increasing value-adding patient care by applying a modified TCAB program
Tuula Antinaho1, Tuula Kivinen2, Hannele Turunen3
1Department of Nursing Science, University of Eastern Finland , Kuopio, Finland and Central Finland Health Care District, Jyväskylä, Finland.
Leadership in Health Services (Bradford, England)
|September 13, 2017
Summary
Implementing a modified Transforming Care at the Bedside (TCAB) program significantly increased registered nurses
Area of Science:
- Nursing Science
- Healthcare Management
- Organizational Psychology
Background:
- Registered nurses' (RNs) time allocation significantly impacts patient care quality and healthcare efficiency.
- Optimizing RNs' working time to focus on value-adding activities is a key challenge in tertiary hospital settings.
- The Transforming Care at the Bedside (TCAB) program offers a framework for improving nursing work environments and patient care delivery.
Purpose of the Study:
- To evaluate a development process using a modified TCAB program to increase RNs' time spent on value-adding patient care.
- To assess the impact of redesigned nursing work models on RNs' working time use in tertiary hospital inpatient units.
Main Methods:
- External observation of RNs' working time use (N=113 in 2011, N=95 in 2013) before and after intervention.
- Implementation of nursing work redesign by 12 multi-professional teams (2012-2013).
- Deductive content analysis of development team memos (N=64) to understand process dynamics.
Main Results:
- Statistically significant increases in value-adding care and direct patient care time for RNs.
- Significant decreases in non-value-added and miscellaneous work categories for RNs.
- Identified impact of changes in nursing work model, division of labor, and work environment on time use.
Conclusions:
- The modified TCAB program effectively increased RNs' engagement in value-adding patient care.
- Clinical RNs' roles as innovators were crucial, but nursing managers' engagement was essential for success.
- The TCAB program is a valuable method for developing RNs' work, applicable even in psychiatric units.
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