Transforming Care at the Bedside


How to cite this paper:

Rutherford P, Lee B, Greiner A. Transforming Care at the Bedside. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2004. (Available on

With so much care being delivered in hospital medical/surgical units, and with an estimated 35 to 40 percent of unexpected hospital deaths occurring on such units, IHI and The Robert Wood Johnson Foundation (RWJF) agreed to work together to create, test and implement changes that will dramatically improve care on medical/surgical units, and improve staff satisfaction as well.
Through an initiative called Transforming Care at the Bedside (TCAB), IHI and RWJF  created a framework for change on medical/surgical units built around improvements in four main categories:
  • Safety and Reliability
  • Care Team Vitality
  • Patient-Centeredness
  • Increased Value
  • This IHI white paper describes work in progress at 13 pilot hospitals, where staff are testing, refining and implementing change ideas within each category. Early results are promising, and the paper offers concrete suggestions for readers who wish to test and implement similar ideas in their own hospitals.
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