Evidence- Based Patient Safety Initiative Introduced in the year 2003, Transforming Care at A Bedside (TCAB) represents a national- level initiative originally formulated and headed by the IHI (Institute for Healthcare Improvement) and RWJF (Robert Wood Johnson Foundation). TCAB ensures leadership involvement at every healthcare institutional level and authorizes front- line nursing staff and other healthcare workers to contribute towards improving healthcare safety and quality on surgical- medical units, increasing nursing personnel retention and vitality, improving overall patient care team efficacy, and engaging patients and their family members to improve their care experience. The following design themes or goals – dependable, safe patient care; value added healthcare processes; vitality and collaboration; and client- focused care – form the elementary framework when it comes to formulation of changes for accomplishing TCAB objectives (Rutherford, Moen & Taylor, 2009).

A number of elements set TCAB apart from other programs targeted at improving quality. Firstly, TCAB attempts at engaging frontline healthcare employees’ and unit heads’ minds and hearts when it comes to care process improvement. With TCAB, novel ideas to transform how care is provided do not merely arise from hospital managers or members of quality improvement units; rather, frontline nursing staff and other healthcare workers who spend maximum time with the patients and family members also provide input. Furthermore, TCAB promotes transformative change. Frontline employees and organizational leaders challenge and prove theories, engage in critical reflection upon personal experiences, and come up with novel models and views. Lastly, TCAB stresses on ongoing discovery and learning. Units test novel theories and constantly attempt to bring about improvements to care processes, learning the method to achieve desired outcomes (Rutherford et al, 2009).

Aged individuals typically display multifaceted clinical and psychiatric requirements, necessitating input from multiple medical disciplines and specialties. Interdisciplinary experts’ participation ensures patients have access to more expertise as compared to that offered by a single clinician. But it has been linked to major challenges in the areas of healthcare integration and coordination. Though the principle of delivering effectively- coordinated interdisciplinary care to aged patients suffering from medical and psychiatric conditions is approved of and supported, it has also been acknowledged that realizing it is difficult and usually inadequate (American Psychiatric Association, 2009).

Though major service provision- related problems and challenges prevail, several noteworthy programs and efforts have been initiated for dealing with them. These include attempts at promoting collaboration in supportive and mental health service delivery; consumer advocacy group organization; supporting studies focusing on aged individuals suffering from mental health conditions; increasing public knowledge of psychiatric/psychological problems; and expanding and better educating geriatric mental healthcare workers. These endeavors offer a sound basis for tackling key challenges pertaining to aged persons’ mental...

The steps that follow serve as the groundwork for the project: determination and dissemination of important policy and initiative- related problems; performance of key research works; creation of clinical practice guidelines; and the organization of local, state and national coalitions and geriatric consumer groups. Several attempts have been backed and implemented using funding from local, state, and national governments and foundations (Department of Health and Human Services Administration on Aging, 2001).
Intervention for Patient Safety

Numerous single interventions exist that have the potential to arrest certain adverse events’ progress, thereby reducing harm. But experience reveals that clinical system reliability and safety improvements call for action at several levels. Thus, for making real progress with regard to improving mental health patient care safety within hospital settings, one will probably require complex interventional packages as opposed to distinct steps. A prior complex conceptual system may be easily applicable to the problem, taking into account the following 7 safety levels: task factors, patient/client factors, staff or individual factors, organizational context factors, environmental factors, institutional factors, and team factors (George, Long & Vincent, 2013):

Task factors. Patient safety is reliant on well- defined, rigorous task design as well as protocol access and utility and requisite patient- connected information. It is imperative to take note of and work on the latest growing tendency of including more aged and frail patients within clinical trials, for developing a sounder evidence pool for optimal patient health management. Increased employment of centralized EHRs (electronic health records) with multiple healthcare stakeholders having access to relevant patient details potentially hard to procure in the initial acute hospitalization stages will improve psychiatric patient safety as well.

Patient/client factors. The golden practice standard at staff and patient levels is the National Mental Issues Strategy (NMIS)- promoted ‘patient- focused strategy’. This involves valuing individuals suffering from mental health problems, cultivating a positive climate for them, regarding them as an individual, and viewing care systems from their standpoint. Respecting patients, showing empathy, and cultivating a suitable environment for them contributes positively to both quality and safety. Hospitals often tend to over- stress mental ailments’ medical components as compared to their psychological and emotional elements. A large number of elements of the complex, delirium- specific ‘Inouyes’ intervention concentrate on the above patient factors. In simple terms, those ailing from mental health problems exhibit far lower likelihood of becoming delirious in the event their care gets directed to aiding them in seeing what they do and hearing what goes on around them, moving around, eating/drinking enough, and getting adequate sleep, within an environment in which individuals talk to them and make them aware of what is happening.

Staff or individual factors. Staff qualities, conduct and competencies which have demonstrated their ability to improve patient safety…