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Transforming care at the bedside

Health Care is in a constant state of change. Boscobel Area Health Care (BAHC) has been selected as one of 16 hospitals in Wisconsin to lead that change through an extensive, 18-month project called TCAB - Transforming Care at the Bedside.

TCAB is a collaborative project of the Wisconsin Hospital Association and Aligning Forces for Quality that aims to improve patient care by directly engaging front-line nurses who work with patients everyday. It is part of an innovative nationwide program led by the Robert Wood Johnson Foundation, the nation's largest philanthropy dedicated to improving the health and health care of all Americans.

"After an extensive application process, we were accepted as one of 18 hospitals to lead this project in Wisconsin. The programs we develop and implement here in Boscobel will be shared with other hospitals throughout the state and nation," said Stephanie Wanek, Director of Nursing for BAHC.

The aims for this program are: Safe and reliable care, vitality and team work, patient centered care, and value added care. The steering committee consists of front-line nursing staff. Members are Darla Karasek, Cheryl Bell, Shannon Potts, Heather Kramer, Kim Wellumson, Toni Lenzendorf, Bethany Wisecup, Stephanie Wanek, Carolyn Miller, Shannon Beestman, and Katy Tomten.

"As members of the nursing team, we directly see what works best for our patients. It is rewarding to bring about ideas for change and see them come about," said Cheryl Bell, CNA/HUC.

Even the simplest changes have had big results. "We did a study to see how much time we spent getting supplies, and which items we used most often. We then created 'nurse servers' so those supplies would be right there, close to the patient. Every minute we save running for supplies is another minute we get to spend with our patient," said Carolyn Miller, CNA.

The nurse servers are just one example of changing processes to reduce wasted time. "Nationwide a nurse spends just 30% of his or her time at the patient's bedside. This project aims to increase that to 60%. With several projects completed, we have already greatly increased the time we get to spend with each patient," said Shannon Beestman, RN.

"As a small facility, we have an inherent ability to provide more personalized care. But we cannot rely on being small alone," said Darla Karasek, RN, who noted that BAHC's emergency room volume has tripled since the new addition opened. "People from all over the area come to BAHC to be seen in our emergency room. We are proud to be able to see this increase in patients without compromising our personalized care. TCAB is an important part of increasing quality and overall efficiency so we can continue to grow," Karasek said.

"We have seen a lot of positive changes at BAHC in the past few years, including a new emergency room with updated equipment, new ER doctors, and electronic medical records," said Bethany Wisecup, RN. "It is exciting to work for a facility that is constantly moving forward. What is different about TCAB is that we are not only making a difference for our patients here in Boscobel, but also for patients nationwide."

The steering committee attends regular TCAB trainings and roundtable meetings to share their successes, learn from the other TCAB hospitals, and move forward together. "It is exciting to share a project we have identified here in Boscobel and see hospitals from large communities, like Madison, adopt our ideas. Likewise, it is rewarding to see what other hospitals are doing and how we can bring those ideas back to our patients," said Katy Tomten, RN.

Patients, family members, and community members can also provide feedback by calling the TCAB hotline and leaving a message. The number is 608-375-6337.

Wisconsin Hospital Association TCAB Project Manager Stephanie Sobsczak said, "We are looking forward to seeing what innovative approves our teams come up with through the TCAB experience. This project will help Wisconsin, which is already known as a national leader in both patient safety and quality, attain an even higher standard of care."