CIT Frequently Asked Questions
Who is eligible to apply to participate in CIT?
AONL members and non-members are eligible to apply for participation in the Traditional CIT program or the new Customized Hospital/System CIT program.
How is CIT similar to TCAB?
There are many key aspects of Transforming Care at the Bedside (TCAB) that will remain part of the CIT program. These include:
- Rapid cyclet tests of change using the PDSA methodology
Learning communities with in person meetings - Learning communities with in person 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 health care organization - The Care Innovation and Transformation program will be closely aligned with AONL’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 or a team. This program will also include:
- Targeted training for nurse managers using AONL'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
All applicants will be asked to identify and describe a unit, team, or department to participate in the care innovation and transformation journey. As a CIT hospital, participating unit teams will be expected to attend four in person meetings during a two-year period; participate in monthly conference calls; submit monthly innovation logs; and commit to spreading CIT to other units at the hospital or health care organization.
What does participation in CIT look like?
All applicants will be asked to identify and describe a unit, team, or department to participate in the care innovation and transformation journey. As a CIT hospital, participating unit teams will be expected to attend four in person meetings during a two-year period; participate in monthly conference calls; submit monthly innovation logs; and commit to spreading CIT to other units at the hospital or health care organization
Who participates in the CIT program?
Inpatient and outpatient unit teams from a variety of hospitals and health care settings (critical access, rural, suburban, urban, academic medical centers, rehabilitation units, and long-term care settings) across the country have participated in past cohorts. Staff nurses, unit leadership, interdisciplinary team members, and support staff make up the unit teams and are supported by the chief nurse and quality leaders.
Is there a way to bring CIT to my organization?
AONL is prepared to deliver a customized CIT program for up to 20 nursing units, teams, or departments at your hospital or health system during an 18-month period. By bringing the program to your hospital or health system, the Center for Care Innovation and Transformation will provide the same CIT training and education benefits to more units and with less expenditure than could be achieved with the traditional off-site program. This collaborative, workshop-style series of lectures and training modules is designed to help nursing unit leaders and their staff improve patient care, hospital performance, and employee engagement. This new customized CIT program is designed to increase the volume of participants while decreasing costs for the participating organization. CIT comes to you and your organization, saving the costs associated with travel. While this new approach limits the interaction unit teams will have with other institutions across the country, you are encouraged to invite your hospital or system’s pre- and post-acute care partners to diversify innovations, enhance relationships, and improve care across the continuum.
What are some outcomes of the TCAB program?
AONE has spread TCAB and CIT to more than 200 nursing 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.
- 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?
Below are two recent publications that suggest methods for calculating the business case for TCAB:
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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 Quarterly 35(2), 97-109.
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Bolton, L. B., & Aronow, H. U. (2009). The business case for TCAB. AJN The American Journal of Nursing, 109(11), 77-80.
What is the cost of the program?
Traditional CIT program - Cost Option 1
The cost-per-hospital or health care team is $9,000 per year for two years. Included in this cost will be the CCIT’s management and coordination of the entire program 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 team members to each of the four in-person 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 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 usage, 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, click here to visit the CIT Time Study page and here to navigate to Rapid Modeling Corporation.
Traditional CIT program - Cost Option 2
Includes everything in Option 1 except the Time Study PDA.
Cost-per-hospital or health care team is $9,000 per year for two years. Included in this cost will be the CCIT’s management and coordination of the entire program 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 team members to each of the four in person 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 participants.
Institutions or systems sending five or more units are eligible for the discounted rate of $7,000 per unit per year. The Center is also able to bring CIT to institutions wanting to enroll a large number of units.
Customized Hospital/System CIT Program
The Center is also able to bring CIT to institutions wanting to enroll up to 20 units, teams, or departments using the new Customized CIT program. This program is cost-effective, spreads the process quickly, and allows for customization.
How long does the program application take to complete?
The application is designed to take approximately one to two hours to complete. Applicants are encouraged to be concise with their responses.
Who should I contact with questions?
If you have any questions about the AONL Care Innovation and Transformation program, you may contact AONL@aha.org or (312) 422-2804.