Friday, July 13, 2007
This presentation is part of : Transforming Care at the Bedside: Evidence-based Practice in a Community Hospital
Nurse-driven Interdisciplinary Collaboration among Patients, Families and Care Providers
Susan Fuchs, BSN, RN1, Cheryl Orzel-Teris, MS, RN1, and Mary Ellen Gaudet, MS, RN, CPHQ2. (1) Nursing, Our Lady of Lourdes Memorial Hospital, Inc, Binghamton, NY, USA, (2) Quality Services Division, Our Lady of Lourdes Memorial Hospital, Inc, Binghamton, NY, USA

Our Lady of Lourdes Memorial Hospital (Lourdes) is a community hospital chosen as a Transforming Care at the Beside (TCAB) research demonstration site by Ascension Health. TCAB involves a radical change in thinking and behavior among all members of the healthcare team. Based on Lewin’s change theory (unfreezing, movement and refreezing) and Everett Rogers’ adopter categories (innovators, early adopters, early majority, late majority and resistors), Lourdes implemented multiple tests of change using the Plan-Do-Study-Act methodology. Critical factors for the success of TCAB include a culture of innovation and safety, interdisciplinary collaboration, endorsement by frontline caregivers, leadership and outcomes that demonstrate fiscal and clinical value.  Pervasive themes for TCAB are safety and reliability, care team vitality, patient centeredness and increased value. 

The goals of TCAB include no unanticipated deaths or needless pain and suffering, elimination of unnecessary documentation, nurses spending 70% of their time at the bedside and patients stating, “I received exactly what I wanted (and needed) when I wanted (and needed) it.” As the hospital moves toward sustaining the TCAB initiative, there is an ongoing need to support an environment that nurtures professional and career development based on evidence.