Engaging Frontline Staff in Performance Improvement: The American Organization of Nurse Executives Implementation of Transforming Care at the Bedside Collaborative

Contextualizing learning to improve care using collaborative communities of practices

“…Our study findings contribute to the evolving literature around the value of using QI collaboratives;[1–4, 7–9] interorganizational learning [5, 6, 10, 11] and collaborative communities-of-practice [13, 14] to build QI capabilities amongst point-of-care clinicians, staff, and managers. Study findings offer insights into the active ingredients of collaborative, inter-organizational communities of practice learning approaches to build QI capabilities amongst point-of-care clinicians, staff, and managers.…”

“…Future research could build on this empirical work and mixed methods approaches used to evaluate similar QI collaborative efforts - Transforming Care at the Bedside [9] and the Betty Irene Moore Nursing Initiative [23]. Specifically, multi-national, multi-site research that employs more rigorous experimental designs that include system, professional, organizational, team-based and patient oriented outcomes and experiences are required.…”

“…The use of interorganizational, collaborative approaches to build capacity in quality improvement (QI) in health care is growing and showing promise as a useful model for scaling up and accelerating interventions that bridge the “know-do” gap to improve aspects of clinical care and provider outcomes [1–9]. Fundamental to a collaborative approach is interorganizational learning whereby organizations acquire, share and combine knowledge with other organizations and have the opportunity to learn from the successes and failures of their peers in improvement areas [6].…”

“…Fundamental to a collaborative approach is interorganizational learning whereby organizations acquire, share and combine knowledge with other organizations and have the opportunity to learn from the successes and failures of their peers in improvement areas [6]. This learning approach aims to create the conditions for collaborative, reflective, and innovative experiential systems that enable collective discussions regarding daily practice issues and finding solutions for improvement by integrating tacit-explicit knowledge [9, 10]. Interactive dialogue occurs by including participants in deliberate learning activities around The Model for Improvement, Plan Do Study Act (PDSA) small scale cycles and QI tools [11] and the application of learning to a QI project, in partnership with a mentor [4–6].…”

Real-Time Reporting of Small Operational Failures in Nursing Care

“…Moreover, failure to use the frontline workers' knowledge of quality problems discards an important source of organizational intelligence for quality improvement [11]. …”