A patient was asked about her experience as part of the discharge process during a recent hospital visit. She responded, “Do you mean did I notice that the same nurse took care of me every day? Yes, I noticed, and it was wonderful. The last time I was here, I had a different nurse every day.” The impetus to develop a consistent working relationship between individual nurses and patients came from the regular quality-improvement meetings of the staff on the hospital unit participating in a Robert Wood Johnson Foundation (RWJF)–funded program called “Transforming Care at the Bedside” (TCAB). In this innovative program, frontline nurses are empowered to work with other frontline staff to develop and present ideas to improve the quality of patient care and their own satisfaction with the work that they do. In several of the TCAB units, the time that floor nurses spent doing nursing tasks (e.g., assessing patient status) as opposed to non-nursing tasks (e.g., hunting for supplies and equipment or emptying garbage cans) on the experimental unit went from 35% to almost 70%, and turnover dropped to near zero—and this was in 2006, before nurses were holding onto their jobs due to the economic downturn that began in 2008. Many of the TCAB units in the original 13 participating hospitals had waiting lists to work there. For many of the nurses in the program, it was the first time that they felt as though their needs, concerns, and ideas were valued by management at the hospital.

By 2010, TCAB had spread to hundreds of hospitals in the United States and globally. This is just one example of the role that foundations can play in providing the financial, technical, and knowledge-related resources to help nurses change their environment and improve the quality of care.