The Business Case for Transforming Care at the Bedside Among the “TCAB 10” and Lessons Learned

Abstract

It is believed that Transforming Care at the Bedside (TCAB) has improved nursing care and nurses' satisfaction. Yet there may also be financial benefits to TCAB. This study estimates the net benefits of implementing TCAB by using data from the original 10 TCAB hospitals. The analysis indicates that, on an average, TCAB units had fewer patient falls with harm and less RN turnover and overtime compared with other hospitals in the United States. Financial benefits calculated from these outcomes were $847 861 per unit from 2004 to 2007. Estimates of costs of TCAB averaged $222 258 per unit. The net benefit per unit was $625 603.

Transforming Care at the Bedside (TCAB): Enhancing Direct Care and Value-added Care

“…These findings have significant implications for organizational acceptance of change processes as well as more tangible financial benefits. If the business of care is respected, the institutional organizational effectiveness is supported (Unruh et al. 2011).…”

“…2009). Unruh et al. (2011) compared outcomes of the original 10 participating TCAB units with national averages of other hospitals and found lower rates of falls with harm, overtime and turnover in TCAB units.…”

“…The TCAB units participating in the original demonstration project experienced lower registered nurse (RN) turnover rates, fewer falls with harm, decreased 30-day readmission rates and increased nursing time in direct patient care (Needleman et al 2009). Unruh et al (2011) compared outcomes of the original 10 participating TCAB units with national averages of other hospitals and found lower rates of falls with harm, overtime and turnover in TCAB units.…”

Early-Career Registered Nurses' Participation in Hospital Quality Improvement Activities

“…7 However, existing reports indicate that RNs' involvement in QI activities in hospitals is not optimal, 3,4,8,9 even with the demonstrated value of staff nurse-led improvements in care, which achieved estimated cost savings of more than $600 000 per year per patient care unit. 10 Several initiatives have been developed at national [11][12][13][14] and regional [15][16][17] levels, and many programs have been initiated by individual hospitals, 18,19 which can boost RNs' engagement in QI. As these initiatives expand, it is important to systematically monitor changes in RNs' participation in QI and determine the progress of nursing workforce contribution to health care improvement efforts.…”

American Organization of Nurse Executives Care Innovation and Transformation Program

“…1,2 One large academic medical center was able to save an estimated $5.6 million between 2007 and 2008 by reducing nurse turnover. Evidence has reported substantial financial savings as a result of improvements for selected outcomes such as nurse turnover, nurse overtime, falls with injury, and hospital-acquired pressure ulcers.…”