Transforming Care at the Bedside (TCAB) Initiative: Addressing the Health Gap Among the Elderly Diabetic Patients

There is a health gap existing in managing diabetes among the elderly in the US. The absence of professional cohesion, support and information contribute to the complexity in the nursing coordination while managing the elderly diabetic patients in healthcare settings CITATION Mel13 \l 1033 (Lavoie-Tremblay, et al., 2013). Inefficiency in healthcare workflow and a shortage of medical personnel widens the health gap. Research shows that the best strategy for reducing the health gap is addressing inefficiency challenges that the health professionals confront in the geriatric units and creating the working environments where there are minimal wasteful work and fashioning settings that facilitate teamwork and communication.

As an attempt to reduce the health inequality, Institute for Healthcare Improvement (IHI) in partnership with Robert Wood Johnson Foundation developed Transforming Care at the Bedside (TCAB) initiative to involve frontline health professionals in creating changes and innovations for improving patient care. The action would impact on the management of diabetic patients in geriatric wards following its objective of redesigning inpatient healthcare delivery procedures through the involvement of interprofessional teams, patients and their families in meeting the elderly patients needs. According to Lavoie-Tremblay, et al. (2013), the TCAB initiatives purpose of involving the elderly patients representatives is to provide guidance in decision making at critical moments.

The specific goal of the initiative is to enhance interprofessional healthcare team communication which would, in turn, facilitate consensus and boost collaboration that aid in the implementation of evidence-based healthcare strategies. From these the goals, there is a likelihood of enhancing health care professionals competence while dealing with chronic diseases and specialties like diabetes (Institute for Healthcare Improvement, 2017). TCAB is thus critical in aged care as it has the other goals of enabling primary care professional to act, evaluate and observe the multifaceted needs that the increasingly aging population demands. Other specific objectives that can impact on aging diabetic patients include the application of Rapid Response Team during the patient crisis and the development of communication modes for supporting clear and consistent communication within the healthcare settings. Furthermore, TCAB liberalizes meal schedules and diet plans for the patients and redesigns workspace for the benefits of enhancing efficiency and patient support programs like educational strategies and preceptorships (Institute for Healthcare Improvement, 2017).

The circumstance around the development of the initiative is the need to reduce the prevalence of unexpected mortality whose rate was between 35% and 40% in 2013. Hence the need for partnership for creating, testing and implementing changes for improving the patient satisfaction and obtaining positive outcomes in the medical-surgical units (Institute for Healthcare Improvement, 2017). Important factors under consideration during the development of the initiative include the five domains in healthcare such as transformational leadership, value-added healthcare processes, patient-centered care, teamwork and vitality, and reliable and safe care. Therefore, with the application of the initiative, there is a possibility of encouraging the hospital leaders and frontline staff to create and implement changes whose ultimate goals are to improve healthcare following the five TCAB domains.

The critical resources necessary for the TCAB viability across the US are majorly financial funds for sustaining innovation in 13 pilot institutions. Financial resources are essential for the acquisition of the tools and equipment for empowering novelty among nurses through training. After the completion of the pilot phase of the initiative in 2008, American Organization of Nurse Executives handles the continuation of the initiative at present. However, the inefficiency of the effort is due to the lack of cooperation from the hospital leadership. There is also little funding despite the increased number of health facilities in the nation. The improvement of the initiative is reliant on the cooperation and participation of the government to consider the action as it strives to strengthen the entire health care sector CITATION Ash13 \l 1033 (Warren, Wyss, Shakarishvili, Atun, & Savigny, 2013). Reinforcing the initiative imply developing and improving the capacity of skills and knowledge enhancement techniques such as training and workshops. Improvement is also achievable by building deploying more human and financial resources and developing increased infrastructure and institutional capacities.

References

BIBLIOGRAPHY Institute for Healthcare Improvement. (2017). Transforming Care at the Bedside (TCAB). Retrieved from Institute for Healthcare Improvement: http://www.ihi.org/Engage/Initiatives/Completed/TCAB/Pages/default.aspx

Lavoie-Tremblay, M., O'Conner, P., Harripaul, A., Biron, A., Ritchie, J., Lavigne, G. L., & Baillargeon, S. (2013). The Effect of Transforming Care at the Bedside Initiative on Healthcare Teams Work Environments. World Views on Evidence-based Nursing, 11(1): 1741-6787.

Warren, A., Wyss, K., Shakarishvili, G., Atun, R., & Savigny, D. d. (2013). Global health initiative investments and health systems strengthening: a content analysis of global fund investment. Globalization and Health, 1(1): 9-39. DOI: 10.1186/1744-8603-9-30.