Medical-surgical units provide care for patients with a wide variety of clinical conditions, including those who are recovering from surgeries, those hospitalized for an acute condition, and others who may be in the final stages of a progressive and chronic disease. Such units form the core of most American hospitals.
According to a 2000 report on the registered nurse population, 30.9 percent of registered nurses work in general or specialty bed units (Spratley et al., The Registered Nurse Population, March 2000. Washington, DC: US Department of Health and Human Services). Due to the myriad of patient diagnoses, multitude of attending physicians, and complex nature of these general care units, multidisciplinary care teams strive to work within confusing systems that are often prone to error, waste, and rework. The stress within these systems often leads to high turnover rates for caregivers and less than ideal experiences for patients.
Hospital teams participating in the Transforming Care at the Bedside initiative and other related IHI programs have made great improvements in safety and care for patients on medical-surgical units and their families, including reduced patient injuries from falls, improved transitions home, increased nurse time in direct care, reduced nurse turnover, and many other improvements.
