Defining Sustainability of Care Delivery in Rural Hospitals: A TCAB Pilot Project

2.50
Hdl Handle:
http://hdl.handle.net/10755/307867
Category:
Abstract
Type:
Presentation
Title:
Defining Sustainability of Care Delivery in Rural Hospitals: A TCAB Pilot Project
Author(s):
Fairchild, Roseanne; Zwerner, Randi; Ferng, Shiaw-Fen
Lead Author STTI Affiliation:
Alpha
Author Details:
Roseanne Fairchild, PhD, RN, CNE, NE-BC, roseanne.fairchild@indstate.edu; Randi Zwerner, MSN, RN; Shiaw-Fen Ferng, Ph.D.
Abstract:

Session presented on: Saturday, November 16, 2013

Robert Wood Johnson’s Transforming Care at Bedside (TCAB) quality improvement (QI) model addresses patient-centered care, value-added productivity, patient safety, employee vitality. Application of the model has been demonstrated to increase quality of care in urban hospitals, but no study has been completed to tailor TCAB and its variable measures to rural hospitals. Based on promising results in urban settings, TCAB needs to be adapted to the unique context of rural hospital settings, including working, managing and measuring on a smaller scale and constrained financial and technological resources.

The purpose of this six-month pilot study was to measure levels of employee vitality and engagement, assess patient health outcome indicators, and highlight unique issues facing rural hospitals to determine revisions needed to TCAB outcome variables for rural hospitals.

Method: Ten qualitative focus groups were conducted with employees (n=37) to gather thematic data regarding unique issues and QI opportunities in rural hospitals. Kriskal-Wallis ANOVA and Mann-Whitney U tests were used to identify differences in employees’ vitality and engagement (n=139/193;72% response rate). Hospital Compare data in the CMS core measures were assessed for below-average scores. The significance level was set at 0.05.

Results: There were statistically significant differences in vitality among administrative, clinical and ancillary staff (p<.030). There were below-average scores in CMS hospital readmissions. Focus group participants revealed multiple innovative ideas to promote QIs in patient education, patient satisfaction, transformational leadership, staff recognition. Recycling was observed to be lacking, but indoor air quality (IAQ), ventilation rate, relative humility, carbon dioxide levels were within-normal-limits.

Conclusions: Revisions to selected TCAB outcome variables are needed to tailor TCAB to rural hospitals. This pilot study should allow development of a set of evidence-based QI strategies and outcomes that are relevant to rural hospitals and can be implemented and tested in a larger group of rural U.S. CAHs.

Keywords:
Rural hospitals; green hospital practices; quality improvement (TCAB)
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleDefining Sustainability of Care Delivery in Rural Hospitals: A TCAB Pilot Projecten_GB
dc.contributor.authorFairchild, Roseanneen_GB
dc.contributor.authorZwerner, Randien_GB
dc.contributor.authorFerng, Shiaw-Fenen_GB
dc.contributor.departmentAlphaen_GB
dc.author.detailsRoseanne Fairchild, PhD, RN, CNE, NE-BC, roseanne.fairchild@indstate.edu; Randi Zwerner, MSN, RN; Shiaw-Fen Ferng, Ph.D.en_GB
dc.identifier.urihttp://hdl.handle.net/10755/307867-
dc.description.abstract<p>Session presented on: Saturday, November 16, 2013</p>Robert Wood Johnson’s Transforming Care at Bedside (TCAB) quality improvement (QI) model addresses patient-centered care, value-added productivity, patient safety, employee vitality. Application of the model has been demonstrated to increase quality of care in urban hospitals, but no study has been completed to tailor TCAB and its variable measures to rural hospitals. Based on promising results in urban settings, TCAB needs to be adapted to the unique context of rural hospital settings, including working, managing and measuring on a smaller scale and constrained financial and technological resources. <p>The purpose of this six-month pilot study was to measure levels of employee vitality and engagement, assess patient health outcome indicators, and highlight unique issues facing rural hospitals to determine revisions needed to TCAB outcome variables for rural hospitals. <p>Method<b>:</b> Ten qualitative focus groups were conducted with employees (n=37) to gather thematic data regarding unique issues and QI opportunities in rural hospitals. Kriskal-Wallis ANOVA and Mann-Whitney U tests were used to identify differences in employees’ vitality and engagement (n=139/193;72% response rate). Hospital Compare data in the CMS core measures were assessed for below-average scores. The significance level was set at 0.05. <p>Results: There were statistically significant differences in vitality among administrative, clinical and ancillary staff (p<.030). There were below-average scores in CMS hospital readmissions. Focus group participants revealed multiple innovative ideas to promote QIs in patient education, patient satisfaction, transformational leadership, staff recognition. Recycling was observed to be lacking, but indoor air quality (IAQ), ventilation rate, relative humility, carbon dioxide levels were within-normal-limits. <p>Conclusions: Revisions to selected TCAB outcome variables are needed to tailor TCAB to rural hospitals. This pilot study should allow development of a set of evidence-based QI strategies and outcomes that are relevant to rural hospitals and can be implemented and tested in a larger group of rural U.S. CAHs.en_GB
dc.subjectRural hospitalsen_GB
dc.subjectgreen hospital practicesen_GB
dc.subjectquality improvement (TCAB)en_GB
dc.date.available2013-12-19T17:23:17Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:23:17Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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