Welcome!

1. Welcome!

2. Welcome! TCAB Cohort 2: 24 Teams 22 Hospitals 171 Here today TCAB Cohort 1: 3 Teams Here Today Guests: 9 hospitals are represented

3. WHA Staff Here Today Judy Warmuth & Stephanie Sobczak – Park Rangers Tom Kaster, WHA Improvement Advisor Jana Klinge, WHA QI Assistant Lisa Littel, WHA Education Dept. Coordinator Mary Kay Grasmick, WHA VP Communications Kelly Court, WHA Chief Quality Officer

4. TCAB in Wisconsin is Supported by: Wisconsin Collaborative for Healthcare Quality through the Aligning Forces for Quality grant by the Robert Wood Johnson Foundation and The WHA Foundation

5. 45 Hospitals have participated in TCAB

6. Picture Taking Mary Kay will be taking pictures of your team, and your display today. We will have a report included in WHA’s Friday newsletter, the Valued Voice. We are also looking to feature a few TCAB units for an article series in the Valued Voice.

7. Logistics In the blue backpack: • Carabiner Rings to make your own Ring of Knowledge • Fun Stuff! On your table: • Agenda for the day • Handouts • Nat’l Park “Passport” • Voting Slips

8. Logistics • 15 minute breaks – morning and afternoon • Lunch will be held in the room next door. You will be served at your tables. • Restrooms – to the far ends of the hallways. • Adjournment – 3:30 at the latest.

9. Just for Fun • Door Prize drawings – at each break. You choose from the prize pile on the table. • Voting on “Best of”s • “Trophy” presentation

10. The TCAB Pillars: Understanding the Foundation

11. Launched in 2003, Transforming Care at the Bedside (TCAB) is a national program of the Robert Wood Johnson Foundation (RWJF) whose goal is to address quality of care on hospital patient care units. • The program engages leaders at all levels of the organization, including the front-line staff to: • improve the quality and safety of patient care • increase the vitality and retention of nurses • engage and improve the patient’s and family members’ experience of care • improve the effectiveness of the entire care team

12. The AIM of Wisconsin’s TCAB • Dedicated to engaging front-line staff in improvement • Providing growth opportunities for staff • An empowerment learning lab for managers and leaders

13. The TCAB Model LEADERSHIP Transformational Leadership at all Levels of the Organization TCAB PILLARS EFFECTIVE CHANGE EFFECTIVE CHANGE

14. The TCAB Model LEADERSHIP Transformational Leadership at all Levels of the Organization COMMUNICATE SYSTEM LEVEL AIMS FOR IMPROVEMENT ALIGN SYSTEM MEASURES, STRATEGY, PROJECTS, CHANNEL LEADERSHIP TO SYSTEM-LEVEL IMPROVEMENT GET THE RIGHT TEAM ON THE BUS ENGAGE PHYSICIANS & LEADERS BUILD CAPABILITY TO IMPROVE TCAB PILLARS EFFECTIVE CHANGE EFFECTIVE CHANGE

15. The TCAB Model LEADERSHIP Transformational Leadership at all Levels of the Organization COMMUNICATE SYSTEM LEVEL AIMS FOR IMPROVEMENT ALIGN SYSTEM MEASURES, STRATEGY, PROJECTS, CHANNEL LEADERSHIP TO SYSTEM-LEVEL IMPROVEMENT GET THE RIGHT TEAM ON THE BUS ENGAGE PHYSICIANS & LEADERS BUILD CAPABILITY TO IMPROVE TCAB PILLARS SAFE & RELIABLE CARE VITALITY AND TEAMWORK PATIENT-CENTERED CARE VALUE-ADDED CARE PROCESSES EFFECTIVE CHANGE

16. The TCAB Model LEADERSHIP Transformational Leadership at all Levels of the Organization COMMUNICATE SYSTEM LEVEL AIMS FOR IMPROVEMENT ALIGN SYSTEM MEASURES, STRATEGY, PROJECTS, CHANNEL LEADERSHIP TO SYSTEM-LEVEL IMPROVEMENT GET THE RIGHT TEAM ON THE BUS ENGAGE PHYSICIANS & LEADERS BUILD CAPABILITY TO IMPROVE TCAB PILLARS SAFE & RELIABLE CARE VITALITY AND TEAMWORK PATIENT-CENTERED CARE VALUE-ADDED CARE PROCESSES Falls with injury on the unit are reduced to zero. Increase vitality and reduce voluntary turnover by 50% Increase nursing direct patient care time at the bedside to 60% 95% of patients satisfied with Nurse Communication EFFECTIVE CHANGE EFFECTIVE CHANGE

17. The TCAB Model Transformational Leadership at all Levels of the Organization LEADERSHIP COMMUNICATE SYSTEM LEVEL AIMS FOR IMPROVEMENT ALIGN SYSTEM MEASURES, STRATEGY, PROJECTS, CHANNEL LEADERSHIP TO SYSTEM-LEVEL IMPROVEMENT GET THE RIGHT TEAM ON THE BUS ENGAGE PHYSICIANS & LEADERS BUILD CAPABILITY TO IMPROVE TCAB PILLARS SAFE & RELIABLE CARE VITALITY AND TEAMWORK PATIENT-CENTERED CARE VALUE-ADDED CARE PROCESSES Falls with injury on the unit are reduced to zero. Increase vitality and reduce voluntary turnover by 50% Increase nursing direct patient care time at the bedside to 60% 95% of patients satisfied with Nurse Communication EFFECTIVE CHANGE EFFECTIVE CHANGE Institute Hourly Rounding Adopt bedside report Organize transitions to other health care facilities Create acuity adaptable beds Reduce “hunting and gathering “ on the unit Consistent falls risk assessment & teaching Implement Shift Change Huddles Involve patients and families on QI teams

18. The TCAB Model LEADERSHIP Transformational Leadership at all Levels of the Organization COMMUNICATE SYSTEM LEVEL AIMS FOR IMPROVEMENT ALIGN SYSTEM MEASURES, STRATEGY, PROJECTS, CHANNEL LEADERSHIP TO SYSTEM-LEVEL IMPROVEMENT GET THE RIGHT TEAM ON THE BUS ENGAGE PHYSICIANS & LEADERS BUILD CAPABILITY TO IMPROVE TCAB PILLARS SAFE & RELIABLE CARE VITALITY AND TEAMWORK PATIENT-CENTERED CARE VALUE-ADDED CARE PROCESSES Hospital acquired pressure ulcers are reduced to zero. Increase vitality and reduce voluntary turnover by 50% Increase nursing direct patient care time at the bedside to 60% 95% of patients satisfied with Nurse Communication EFFECTIVE CHANGE EFFECTIVE CHANGE Institute Hourly Rounding Adopt bedside report Organize transitions to other health care facilities Create acuity adaptable beds Reduce “hunting and gathering “ on the unit Consistent falls risk assessment & teaching Implement Shift Change Huddles Involve patients and families on QI teams

19. Park Ranger Visits During the Ring of Knowledge time this afternoon, Judy and Stephanie will visit and ask to see your TCAB Pillars.

20. Where are we now?Stephanie Sobczak

21. How do you know your efforts have resulted in improvement?

23. Innovations Since August of 2012, these TCAB teams have conducted many small tests of change and adopted many best practices and innovations 576 How many?

24. Goals

25. Achievable Goals

26. Achievable Goals

27. Achievable Goals

28. Achievable Goals

29. Current Results

30. Current Results

31. Keep working Learn from your data Improve systematically – small tests of change are the key! Engage more and more of your colleagues This is hard work!

32. Engaging Hearts and MindsJudy Warmuth “Quality improvement begins with love and vision. Love of your patients.Love of your work. If you begin with technique, improvement won’t be achieved.” --A. Donabedian, M.D

33. Engagement Exercise What TCAB has meant to …. Our patients and families? Our unit? Our hospital? Me? Find someone you don’t know & Have a conversation

34. Engagement Exercise What TCAB has meant to …. Our patients and families? Our unit? Our hospital? Me? 15 minutes

35. Engagement Exercise What TCAB has meant to …. Our patients and families? Our unit? Our hospital? Me? • Report out: • Judy • Stephanie • Volunteer sharing

36. Visiting the National Parks this afternoon You will need your Passports! • Visit each of the National Parks • Keep someone ‘on duty’ at your park • Get a sticker for your passport • Watch for the Park Rangers! • Don’t forget to vote!

37. Visiting the National Parks this afternoon You will need your Passports! • Visit each of the National Parks • Keep someone ‘on duty’ at your park • Get a sticker for your passport • Watch for the Park Rangers! • Don’t forget to vote!

38. Award Categories Newest Idea You Want to Steal Most Impressive Outcome Best Use of National Parks Theme

39. Place your Votes in the Backpack for Each Category

40. Introducing Carrie Brady

41. Break Time!

42. Lunch Time!

43. Break Time!