Center for Innovation in Care Delivery Programs and Initiatives

Programs & Initiatives

Keeping patients safe

Transforming Care at the Bedside

Transforming Care at the Bedside (TCAB) is an initiative of the Robert Wood Johnson Foundation (RWJF) in partnership with the Institute for Healthcare Reform (IHR). MGH was one of 68 hospitals nationally to participate in the third round of this initiative administered by The American Organization of Nurse Executives (AONE).

TCAB has several “visions” for nursing:

that the work environment is a joyful and supportive one in which to practice
that patients receive safe, reliable, effective, equitable hospital care
that care be truly patient-centered and
that all care processes are free of waste and promote continuous flow

In the two years of participation in the national study, White 10 served as the TCAB unit. During that time the staff of White 10 under the leadership of Amanda Stefancyk, RN, MSN, MBA tested over 30 ideas to improve patient and family centered care of which 11 have been incorporated into the daily practice on the unit. A very successful example is moving frequently used supplies to the bedside. This change has saved nurses thousands of steps and hundreds of minutes each month thus freeing them up to spend more time in direct patient care. Plans are currently under way to bring TCAB to other Medical and Surgical units within MGH. To learn more about the TCAB program nationally go to www.rwjf.org/pr/product.jsp?id=30051

Workforce development

Transitioning to Geriatrics and Palliative Care: An RN Residency Program

The RN Residency: Transitioning to Geriatrics and Palliative Care is an MGH educational program funded in part by the Health Resources and Service Administration (HRSA). The purpose of the RN Residency Program is to increase the knowledge and competencies of nurses who care for older patients in order to improve the quality of care for older patients and those approaching the end of their lives. The program is completing its final year of a three year cycle. To date, 109 registered nurses throughout MGH as well as the North End Nursing Home have completed this ground breaking program. They have formed intergenerational teams, which apply their learning and they have developed appropriate skills to improve the care of a geriatric population.

Patient and Family Centered Care

As part of the effort to enhance knowledge and clinical competence in geriatrics and palliative care the Center for Innovation has expanded the concepts of the RN residency program to include work with the MICU staff.

The MICU is an 18 bed critical care medical unit. Twenty percent of critical care patients die while hospitalized in critical care units thus MICU critical care nurses care for significant numbers of dying patients. Many patients are unconscious and life and death decisions frequently have to be made by the family or a proxy. The Center is actively involved with physicians and nurses in the MICU in order to develop care that addresses the needs of the family as well as the patient. The plan is to restructure communications and have physicians and nurses participate in a family meeting training module. This will ensure that every patient and their family will have the opportunity to have a family meeting within 48 hours of the patient’s admission to the unit. This represents a major advancement in how staff communicate with and support patients and families during very stressful times.

Embedding excellence in practice

Communication Skills

Clear, concise and timely communication is critical to providing high quality, safe care as well as enhancing patient and family satisfaction. The members of our multicultural workforce hail from around the world and bring with them a rich tapestry of knowledge, experience and cultural and clinical skills. For many, English is a second language. The Accent Reduction pilot program is designed as an intensive 8 week program to assist clinicians in strengthening their communication skills. Sponsored by the Center for Innovation and in collaboration with the Multicultural Task Force and staffed by Department of Speech, Language and Swallowing Disorders & Reading Disabilities .

Innovation Skill Development and Device Development

The Center for Innovation sponsors brown bag lunches for PCS staff who are working with the Center. The goal is to help build a community of innovators within PCS. There are often guest speakers.

If you are interested in learning more contact us at Innovation@partners.org.