Evidence- Based Patient Safety Initiative
Introduced in the year 2003, Transforming Care at A Bedside (TCAB) represents a national- level initiative originally formulated and headed by the IHI (Institute for Healthcare Improvement) and RWJF (Robert Wood Johnson Foundation). TCAB ensures leadership involvement at every healthcare institutional level and authorizes front- line nursing staff and other healthcare workers to contribute towards improving healthcare safety and quality on surgical- medical units, increasing nursing personnel retention and vitality, improving overall patient care team efficacy, and engaging patients and their family members to improve their care experience. The following design themes or goals – dependable, safe patient care; value added healthcare processes; vitality and collaboration; and client- focused care – form the elementary framework when it comes to formulation of changes for accomplishing TCAB objectives (Rutherford, Moen & Taylor, 2009).
A number of elements set TCAB apart from other programs targeted at improving quality. Firstly, TCAB attempts at engaging frontline healthcare employees’ and unit heads’ minds and hearts when it comes to care process improvement. With TCAB, novel ideas to transform how care is provided do not merely arise from hospital managers or members of quality improvement units; rather, frontline nursing staff and other healthcare workers who spend maximum time with the patients and family members also provide input. Furthermore, TCAB promotes transformative change. Frontline employees and organizational leaders challenge and prove theories, engage in critical reflection upon personal experiences, and come up with novel models and views. Lastly, TCAB stresses on ongoing discovery and learning. Units test novel theories and constantly attempt to bring about improvements to care processes, learning the method to achieve desired outcomes (Rutherford et al, 2009).
Aged individuals typically display multifaceted clinical and psychiatric requirements, necessitating input from multiple medical disciplines and specialties. Interdisciplinary experts’ participation ensures patients have access to more expertise as compared to that offered by a single clinician. But it has been linked to major challenges in the areas of healthcare integration and coordination. Though the principle of delivering effectively- coordinated interdisciplinary care to aged patients suffering from medical and psychiatric conditions is approved of and supported, it has also been acknowledged that realizing it is difficult and usually inadequate (American Psychiatric Association, 2009).
Though major service provision- related problems and challenges prevail, several noteworthy programs and efforts have been initiated for dealing with them. These include attempts at promoting collaboration in supportive and mental health service delivery; consumer advocacy group organization; supporting studies focusing on aged individuals suffering from mental health conditions; increasing public knowledge of psychiatric/psychological problems; and expanding and better educating geriatric mental healthcare workers. These endeavors offer a sound basis for tackling key challenges pertaining to aged persons’ mental...
References
American Psychiatric Association. (2009). Integrated care of older adults with mental disorders. Retrieved from https://www.psychiatry.org/.../Psychiatrists/Directories/.../rd2009_IntegratedCare.pdf
Brennan, T. A., Leape, L. L., Laird, N. M., Hebert, L., Localio, A. R., & Lawthers, A. G. (1991). Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med, 324(6), 370-376.
Department of Health and Human Services Administration on Aging. (2001). Older adults and mental health: Issues and opportunities. Retrieved from https://www.public-health.uiowa.edu/icmha/training/documents/Older-Adults-and-Mental-Health-2001.pdf
George, J., Long, S., & Vincent, C. (2013). How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions. J R Soc Med, 106(9), 355-361.
Kable, A., Gibberd, R., & Spigelman, A. (2008). Predictors of adverse events in surgical admissions in Australia. Int J Qual Health Care, 20(6), 406-411
Long, S. J., Brown, K. F., Ames, D., & Vincent, C. (2013). What is known about adverse events in older medical hospital inpatients? A systematic review of the literature. Int J Qual Health Care, 25(5):542-54.
McKay, R., & Casey, J. (2015). Psychiatry services for older people. Retrieved from https://www.ranzcp.org/Files/Resources/Reports/RPT-FPOA-Psychiatry-services-for-older-people-revi.aspx
Merten, H., Zegers, M., De Bruijne, M. C., & Wagner, C. (2013). Scale, nature, preventability and causes of adverse events in hospitalised older patients. Age Ageing, 42(1), 87- 93.
Rutherford, P., Moen, R., & Taylor, J. (2009). TCAB: The how and the what. AJN, 109(11). Retrieved from http://forces4quality.org/af4q/download-document/3571/Resource-TCAB__The__How__and_the__What_.3.pdf
Steeg, L. (2016). Improving safety and quality of care for older hospitalized patients A mixed methods approach focusing on delirium and e-learning. Retrieved from https://www.nivel.nl/sites/default/files/bestanden/Proefschrift_improving_safety_quality_care_older_Steeg.pdf
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