Process improvement
Featuring Yvonne Bilak-Krause, MS, RN, Director, 6 West
In 2006, Children’s Memorial Hospital was one of 13 hospitals chosen nationwide to participate in Transforming Care at the Bedside (TCAB), a prestigious initiative in quality improvements in hospital-based patient care on medical/surgical units sponsored by the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement.
“Participating in TCAB was a wonderful opportunity for Children’s Memorial,” states Yvonne Bilak-Krause, Nursing Director for 6 west. “We met four times a year with the other hospitals to discuss tests of change and how to improve patient care.”
The four main categories targeted at improvement for overall better patient care, included safe and reliable care; vitality andteamwork; patient-centered care and value-added care processes. The TCAB process starts with team members suggesting an idea to improve patient care or a particular patient situation. The idea is then tested in a very short period of time and from that one test, the team determines its value and effectiveness. The goal is to avoid long approval processes that involve too many constituents and, in turn, may dilute the positive outcome of the original idea. “It provides the autonomy to think and act fast on behalf of the patient,” Yvonne says. “It has empowered staff. Nurses are more likely to become involved when they feel they can bring ideas to the table.”
One test of change that has made a big impact in our processes,” Yvonne notes, “is the creation of a Critical Assessment Team.” The Critical Assessment Team is a group of expert clinicians who provide support to the bedside nurse when a second opinion is needed in patient care management.
In the third phase of the TCAB initiative, Dr. Kim Amer-Siarkowski, PhD, RN, who started her career at Children’s Memorial and is now an associate professor in the Nursing Department at DePaul University, joined the group. “It’s about giving nurses the ability to make change happen and to create a solution — in the best interests of the patients.”
Kim compiled TCAB findings and built a framework for it in DePaul’s Quality and Safety Training curriculum. “Thanks to the RWJ Foundation and their commitment to nursing education, we were able to participate. We have blended the findings into our graduate level curriculum.”
TCAB is in its final year, however, the results and positive outcomes will continue. Yvonne was honored to be a part of this important initiative. “Children’s Memorial’s participation in this esteemed project is testament to our commitment to patient and family-centered care.”
[Note: This article is included in the 2008 Nursing Report.]