Transforming Care at the Bedside with patients' involvement: Impact on human resources practices

The Institute for Healthcare Improvement (IHI) and the Robert Wood Johnson Foundation developed the Transforming Care at the Bedside (TCAB) program in order to improve efficiency in health care organizations. The TCAB framework consists of five foci where change should be directed, these include (1) safe and reliable care, (2) vitality and teamwork, (3) patient centered care, (4) value added processes, and (5) transformational leadership competencies (IHI, 2012). Since 2010, the McGill University Health Center (MUHC, Montréal, Québec, Canada) has joined the TCAB initiative and innovated with the inclusion of patienst’ representatives. The TCAB program with patient involvement was carried out in five units of the MUHC. In order to better understand how healthcare workers and managers experienced the TCAB initiative after an 18 months involvement, we conducted 9 focus groups and 13 individual interviews for a total of 73 participants interviewed. The data from the focus groups and interviews were analyzed following the method described by Miles and Huberman (1994). Administrative documents were reviewed to collect administrative data. Results from the interviews suggest that the TCAB strategies had a positive impact on practice, work environment, and communication. Healthcare workers and manager gained from having the point of view of patients' representatives as they brought to the table new and valuable information that benefited the decision making process.  Results from the administration data suggested an improvement in terms of turnover and turnaround but no changes were found in terms of absenteeism. The implications of the present results will be discussed.