Care Innovation and Transformation FAQs

    
"Using time/motion technology, hospital units participating in the TCAB initiative outperformed control units in the same hospital in measures of value-added care, direct care, and time in the patient's room."

- Rapid Modeling Corporation, 2009

Who is eligible to apply to participate in CIT?
How is CIT similar to TCAB?
What is new?
What does participation in CIT look like?
Who participates in the CIT initiative?
What are some outcomes of the TCAB initiative?
Is there a business case for TCAB?
What is the cost of the initiative?
What is the timeframe of the call for applications and the program?
Will hard copy applications be accepted?
Who should I contact with questions?

Who is eligible to apply to participate in CIT?
All AONE members and non members are eligible to apply for participation in a CIT cohort.

How is CIT similar to TCAB?
There are many key aspects of TCAB that will remain part of the CIT initiative.  These include:

  • Working with Medical / Surgical units
  • Rapid cycle tests of change using the PDSA methodology
  • Learning communities with face-to-face meetings
  • Required leadership and financial support from the CNO and CEO
  • Rigorous program of innovation and data collection
  • Ongoing sharing of successes and challenges among the participating hospitals

What is new?
The Care Innovation and Transformation initiative will be closely aligned with AONE’s strategic plan, focusing on the role of the nurse manager as the key leader for transformation and culture change on the selected inpatient unit.  This initiative will also include:

  • Targeted training for nurse managers using AONE’s vast array of resources for nurse leadership development and growth
  • Providing quality improvement tools to the nurse leader
  • Linking the work of quality improvement, leadership development, and innovation to the national health care reform agenda

What does participation in CIT look like?
All applicants will be asked to identify and describe an inpatient unit as the pilot unit to participate in the care innovation and transformation journey.  As a CIT hospital, participating unit teams will be expected to attend four face-to-face meetings over a two-year period; participate in monthly conference calls; submit monthly innovation logs; participate in the confidential submission of unit quality data on a quarterly basis; and commit to spreading CIT to other units at the hospital.

Who participates in the CIT initiative?
Inpatient unit teams from a variety of hospitals (critical access hospitals, rural, suburban, urban, and academic medical centers) across the country have participated in past cohorts.  Staff nurses, unit leadership, and support staff make up the unit teams and are supported by the chief nurse and quality leaders.

What are some outcomes of the TCAB initiative?
AONE has spread TCAB and CIT to over 150 hospital units throughout the country.  One cohort of 32 hospitals recently completed a two year journey and collectively tested 926 innovations.  Examples of the innovations included the addition of a discharge nurse to decrease the time of patient discharge; the implementation of bedside report that contributed to a decrease in fall and pressure ulcer rates, as well as incremental overtime; and a change in medication practices that resulted in fewer missing medications leading to a decreased amount of time nurses spent calling pharmacy for medications.

Is there a business case for TCAB?
Yes.  A recent publication suggests one method for calculating the business case for TCAB:  Unruh, L., Agrawal, M., & Hassmiller, S. (2011).  The business case for transforming care at the bedside among the “TCAB 10” and lessons learned.  Nursing Administration Quality 35(2), 97-109.

What is the cost of the initiative?
Cost Option 1

  • The cost per hospital unit is $9,000 per year for two years.
  • Included in this cost will be the CCIT’s management and coordination of the entire initiative including: meeting management; consultation; webinars and conference calls; education including training on rapid cycle change and “train-the-trainer;” management/analysis of data and distribution of unit-level reports. 
  • Costs include registration fees for up to five hospital team members to each of the four face-to-face mandatory meetings.  Additional participants are welcome to attend for a $200 fee to cover meals and resources.
  • Costs not included in the above fee are travel and lodging for hospital unit participants.
  • For an additional, one-time fee of $5,000, the CIT hospital unit will be able to benefit from the use of the Time Study RN personal digital assistant (PDA) developed by Rapid Modeling Corporation to track nurse time and motion throughout the shift.  Users of this technology will be able to track where and how nurses are spending their time thereby allowing participants to develop innovations to decrease non value-added time and increase time at the bedside. This price includes two PDAs, education on use, product support, monthly data reports, as well as the option to participate in a national database to benchmark your unit’s performance against like hospitals. For more information on this technology visit: http://www.rapidmodeling.com/index.php?option=com_content&view=article&id=68&Itemid=81

Cost Option 2

  • Includes everything in Option 1 except the Time Study PDA.
  • Cost per hospital unit is $9,000 per year for two years.
  • Included in this cost will be the CCIT’s management and coordination of the entire initiative including: meeting management; consultation; webinars and conference calls; education including training on rapid cycle change and “train-the-trainer;” management/analysis of data and distribution of unit-level reports. 
  • Costs include registration fees for up to five hospital team members to each of the four face-to-face mandatory meetings.  Additional participants are welcome to attend for a $200 fee to cover meals and resources.
  • Costs not included in this fee are travel and lodging for hospital unit participants.

What is the timeframe of the call for applications and the program?

  • November 15 - Deadline for applications
  • November 20 - Applicants will be notified of acceptance
  • March 2013 - Meeting 1 to take place
  • March 1, 2013 - Year 1 payment due ($9,000)
  • March 1, 2013 - Payment for PDAs due (if applicable)
  • Fall 2013 - Meeting 2 to take place
  • February 1, 2014 - Year 2 payment due ($9,000)

Will hard copy applications be accepted?
No, hard copy applications will not be accepted. All applications must be uploaded via the AONE CCIT website.

Who should I contact with questions?
If you have any questions about the AONE Care Innovation and Transformation initiative, you may contact Amanda Stefancyk by phone at 312.422.2813 or by e-mail at astefancyk@aha.org.