Lavoie-Tremblay Mélanie, O'Connor Patricia, Biron Alain, Lavigne Geneviéve L, Fréchette Julie, Briand Anaïck
Author Affiliations: Ingram School of Nursing, McGill University and McGill University Health Centre (MUHC) (Dr Lavoie-Tremblay); Patient Engagement and the McGill Nursing Collaborative, MUHC, and Ingram School of Nursing, McGill University (Ms O'Connor); Quality, Patient Safety, and Performance, MUHC and Ingram School of Nursing, McGill University (Dr Biron), and Ingram School of Nursing, McGill University (Dr Lavigne and Ms Fréchette) and TCAB and CSI, MUHC (Ms Briand), Montreal, Quebec, Canada.
Health Care Manag (Frederick). 2017 Jan/Mar;36(1):10-20. doi: 10.1097/HCM.0000000000000142.
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). The intervention was composed of 4 learning modules, each lasting 12 to 15 weeks of workshops held at the start of each module, combined with hands-on learning 1 day per week. Transforming Care at the Bedside teams also selected 1 key safety indicator to improve throughout the initiative. Pretest and posttest differences indicate improvement on the 5 team effectiveness subscales. Improvement in vancomycin-resistant Enterococcus rate was also detected. No significant improvement was detected for patient experience. These findings call to attention the need to support ongoing quality improvement competency development among frontline teams.
