were communication problems, handoffs were timeconsuming,
and many staff members reported feeling
uninvolved and unappreciated. Therefore, the
staff and leadership were open to participating in an
innovative project thatwould help themtransformthe
way they worked. We ended up not only improving
communication, but also creating a new unit that is
centered on the TCAB philosophy.
CHANGE OF SHIFT REPORT
The standard practice for giving change of shift
reports was for the off-going nurses to audiotape
reports about every patient on the unit, which all
on-coming patient-care personnel listened to together
in a conference room. The report generally took
between 30 and 40 minutes. Staff members proposed
moving the shift report to the bedside to save time,