The Relationship Between the Volume and Type of Transforming Care at the Bedside Innovations and Changes in Nurse Vitality

Abstract

Through an initiative called Transforming Care at the Bedside (TCAB), the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement have created an innovative bottom-up framework for redesigning the work environment on medical-surgical units. The specific purpose of this study, conducted by the University of California Los Angeles/RAND evaluation team, was to examine the number of innovations tested and the association of the volume of tests made and changes in a summary measurement of self-reported vitality at the 13 participating hospitals. The findings of this evaluation yielded several important implications for nurse leaders.

Transforming care in nursing: a concept analysis

“…Evidence-based change is another attribute of 'Transforming care', which has been Martin et al, 2007;Nelson and Massey, 2010;Rutherford et al, 2008;Roussel et al, 2012;Stefancyk, 2008a,b;Stefancyk, 2009a,b,c;Upenieks et al, 2008;Valente, 2011;Viney et al, 2006). Since new evidence is being continually made available, this attribute provides 'Transforming care' with endless possibilities and, thus, with potential for greater effectiveness (Lee and Upenieks, 2008;Rutherford et al, 2008;Upenieks et al, 2008).…”

“…This attribute determines that the 'Transforming care' approach incorporates patients' and families' needs, preferences and values into the prioritisation and development of care improvements (DiGioia, Embree, & Shapiro, 2011;Chaboyer et al, 2010;Martin et al, 2007;Nelson and Massey, 2010;Scott-Smith and Greenhouse, 2007;Stefancyk, 2008a,b;Rutherford et al, 2008;Roussel et al, 2012;Upenieks et al, 2008;Valente, 2011;Zager and Walker, 2005;). Indeed, 'Transforming care' advocates for participatory processes of change in which stakeholders are empowered to take part in decision-making in relation to their care (Burston et al, 2015).…”

“…The former improvement refers to the 'vitality' of staff (Rutherford et al, 2008, p. 4). This term is used to allude to a high levels of positive attitude and commitment towards the daily work of nursing staff, which favours the recovery of their 'joy of working' and, in turn, the quality of care (Martin et al, 2007;ScottSmith and Greenhouse, 2007;Upenieks et al, 2008;Viney et al, 2006). Teamwork changes associated with 'Transforming care' refer to improvements in the working environment that support the empowerment and inspiration of front-line staff, multi-professional teams, managers and patients to partner together for the advancement of care (Lavoie-Tremblay et al, 2013;.…”

“…Since new evidence is being continually made available, this attribute provides 'Transforming care' with endless possibilities and, thus, with potential for greater effectiveness (Lee and Upenieks, 2008;Rutherford et al, 2008;Upenieks et al, 2008).…”

“…It implies two key features: firstly, that a particular leadership style should be adopted if 'Transforming Care' is to be fully developed; and that this leadership role should be held by front-line nursing managers so as to enable improvements to emerge bottom-up rather than top-down (Martin et al, 2007;Nelson and Massey, 2010;Rutherford et al, 2008;Upenieks et al, 2008).…”