The four main themes of TCAB — Safe and Reliable Care, Vitality and Teamwork, Patient-Centered Care, and Value-Added Care Processes — are guided by the Institute of Medicine's aims for care. These categories serve as a framework for organizing and focusing this work, but they are not mutually exclusive; working in one area can produce positive change in another.

IHI believes that only by working in all four categories simultaneously will care teams produce truly transforming results that move care closer to TCAB’s broader targets:

• Adverse events are reduced to 1 (or less) per 1,000 patient days
• 25% reduction in deaths on the TCAB unit
• 95% compliance with all key clinical process measures (all-or-nothing measure) for the three top clinical conditions on the TCAB unit
• 95% of clinicians, students, and staff say, “I work within a supportive environment that nurtures my professional formation and development”
• 95% of clinicians, students, and staff say, “I am part of an effective work team that continuously strives for excellence even when the conditions are less than optimal”
• 95% of patients are willing to recommend and are satisfied with physical comfort, emotional support, and respect for their values and preferences
• Clinicians spend 70% of their time in direct patient care
• Clinicians spend 90% of their time in value-added activities

View the TCAB framework and examples of transformational changes