Implemented in over 68 hospitals, the RN Labor Management Initiative’s Transforming Care at Bedside (TCAB) program increases the amount of time staff spends at the bedside by reducing time spent on administrative tasks. A quality improvement program initially developed and led by the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement, TCAB has also been piloted in a few 1199SEIU institutions as part of a performance improvement initiative.

At Beth Israel’s Petrie Division, for instance, data collected with hand-held PDA devices monitored which activities take time away from direct care, helping managers determine how to increase the time spent with patients. The TCAB team at Beth Israel implemented an electronic process for requesting medications, eliminating time spent waiting at the pharmacy and away from patients. They also established a new form of communication to decrease distractions and interruptions while medications are being administered: blue medication safety vests are worn by nurses and all non-urgent calls and other interruptions are put on hold to ensure that patients receive their medication in a safe and timely manner. These initiatives have resulted in a significant increase in nurse and patient satisfaction.