Transforming Care at the Bedside



EMMC’s (Eastern Maine Medical Center) Transforming Care at the Bedside program, also known as TCAB, is truly changing the way clinical staff care for their patients. In the four years that the program has been active, it has not only made huge strides in patient safety, but has resulted in cost savings as well.

The program began in 2009 when EMMC’s Grant 6 Respiratory and Grant 6 Oncology were selected to participate with fifteen other hospitals in the Aligning Forces for Quality: Transforming Care at the Bedside Collaborative. The goals of TCAB focuses on improving the quality and safety of patient care, increasing the vitality and retention of nurses, engaging patients and families to improve the patient experience, and improving the effectiveness of the entire care team through staff nurse driven innovations. Today, the program has grown; eleven nursing units currently participate in the hospital’s TCAB program - Grant 6 Respiratory, Grant 6 Oncology, Grant 5, Cardiac Telemetry, Merritt 3 Surgical, Acute Rehab, ICU, CCU, ED, CancerCare of Maine – Radiation Oncology and CancerCare of Maine - Medical Oncology.


"Rising Stars" and the "Grab and Go Bags" initiatives are two examples of TCAB initiatives that have made positive ripples throughout EMMC. Grant 6 was the first to introduce the "Rising Star" program to EMMC and the premise is simple, but effective. Colored stars representing the patient’s ambulation status are displayed at the entrance to the patient room. These colored stars help to prevent unnecessary falls because non-nursing staff is now able to more easily determine if a patient should be attempting to move on their own or not. This innovation is now a hospital-wide standard and has been adopted and "adapted" by other departments to better identify patient needs. The "Grab and Go" bags, created by staff nurses on Grant 5, contain everything the nurse needs to identify the patient as a fall risk, saving valuable time gathering supplies.

Patient safety data is already proving that these two innovations are a huge win for EMMC. The hospital has reported a 43 percent decrease in total falls when comparing data from the first quarter of FY2012 with the first quarter of FY2013. These two innovations are also a financial win. The Centers for Disease Control reports that, as of 2002, the average cost of a fall is between $9000 and $13,000. EMMC has predicted that this decrease in total falls has saved the hospital between $720,000 and $1,040,000.

At a regional meeting of the TCAB national collaborative, staff engagement was recognized as the number one predictor of patient mortality as well as a predictor of hospital complication rates. The success of TCAB at EMMC recognizes staff nurse engagement not only by the valuable contribution they play in the care, but also as informal leaders within this organization. TCAB has become a way of life and the innovations inspired by the bedside nurse will continue to improve the quality of care provided to
EMMC patients.


Editor’s Note: Successful TCAB programs have also started at Inland Hospital and TAMC.     CA Dean has a program in development.

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