This is another article about the effect of TCAB (Transforming Care at the Bedside) on the satisfaction of nurses. As a member of my organization’s TCAB committee, I can see the benefit of this process for all nurses. This small adjustment in the way “things have always been done” can make a huge difference in the way the shift flows and in the patient’s view of the care they are receiving. Nurses who are satisfied with their work will give better care and have more satisfied patients.
Healthcare leadership is well aware that many tasks keep nurses away from the bedside. There are the obvious ones, such as documentation, collecting medications, and hunting equipment. And there are the not-so-obvious ones, such as answering phone calls from patients’ concerned relatives.
Although a relatively minor clinical concern in a nurse’s day, relatives tend to call to check on patients right when nurses are first beginning their shift, when they are trying to hear reports and check in on their patients for the day.
To make the process simpler, nurses at Chilton Memorial Hospital in Pompton Plains, NJ, decided to designate a specific time for relatives to call.
The decision is part of the organization’s larger Transforming Care at the Bedside initiative, says Joanne Reich, VP and chief nursing officer at Chilton. The TCAB initiative is sponsored by the Robert Wood Johnson Foundation and the New Jersey Hospital Association with a goal to improve the quality of care on medical/surgical units.
“Our emphasis is on nursing staff taking a critical look at their care environment and how they can increase their satisfaction and effectiveness in care delivery,” says Reich. “Nurses have many interruptions, so they have been working on increasing time at the bedside.”
Nurses began tracking the number of calls they were receiving from families of patients and discovered the calls used up a significant amount of time and called them are away from the bedside just as they had started assessing their patients or receiving reports.
Having a designated time for families allows patients and families to coordinate the best time in the morning for them to call. Nurses now can plan their mornings better. They can accomplish what they need to do at the start of the shift, and they can ensure they are ready with the information needed when they know the call is coming.
The change was supported by leadership and has worked very well. “Nursing leadership recognizes the leader within each nurse,” says Reich, “and that each nurse is a professional and can bring to the table what they feel works best.”
Nurses also revamped how patient call bells are treated. In a collaborative project with other disciplines, such as physical therapy and respiratory therapy, the hospital created a “no pass zone.”
“It’s a commitment by all of the staff that if patient call bell is lit, no one will pass that room,” says Reich, “without going in and introducing themselves and seeing what’s the patient needs.”
Often, the staff member will be able to help the patient, such as by refilling a water pitcher, which increases patient satisfaction. If the staff member can’t help, he or she quickly takes the issue to the patient’s nurse.
Reich says the next project nurses are tackling will examine patient environment. This more in-depth project requires consideration of different concepts and ideas to determine what is best for patients and what is needed to implement the ideas.
“They want to ensure the patient environment is prepared in the manner that works best for patients,” says Reich. “They’re examining if patients have what they need in the way of water, tissues, food tray, etc. Our goal continues to be providing quality, personalized care to each of our patients. ”
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