Through an initiative called Transforming Care at the Bedside (TCAB), the Institute for Healthcare Improvement (IHI) and the Robert Wood Johnson Foundation created a framework for change on medical-surgical units built around innovations and improvements in four main categories:
These four categories serve as a framework for organizing and focusing work to improve care on medical-surgical units, 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 transformational results.
In each of the four categories listed above, you will find detailed descriptions of several specific changes you can test. In order to transform the care on a medical-surgical unit, organizations must make system-level changes, as well as changes in individual care units and processes.