title: Effective Strategies to Spread Redesigning Care Processes Among Healthcare Teams.
abstract: OBJECTIVE
  The purpose of this study was to describe how spread strategies facilitate the successful implementation of the Transforming Care at the Bedside (TCAB) program and their impact on healthcare workers and patients in a major Canadian healthcare organization.
  
  
  METHODS
  This study used a qualitative and descriptive design with focus groups and individual interviews held in May 2014. Participants included managers and healthcare providers from eight TCAB units in a university health center in Quebec, Canada. The sample was composed of 43 individuals.
  
  
  METHODS
  The data were analyzed using NVivo according to the method proposed by Miles and Huberman.
  
  
  RESULTS
  The first two themes that emerged from the analysis are related to context (organizational transition requiring many changes) and spread strategies for the TCAB program (senior management support, release time and facilitation, rotation of team members, learning from previous TCAB teams, and engaging patients). The last theme that emerged from the analysis is the impact on healthcare professionals (providing front-line staff and managers with the training they need to make changes, team leadership, and increasing receptivity to hearing patients' and families' needs and requests).
  
  
  CONCLUSIONS
  This study describes the perspectives of managers and team members to provide a better understanding of how spread strategies can facilitate the successful implementation of the TCAB program in a Canadian healthcare organization.
  
  
  CONCLUSIONS
  Spread strategies facilitate the implementation of changes to improve the quality and safety of care provided to patients.
authors.affiliation: Associate Professor, Ingram School of Nursing McGill University, Nurse Scientist, McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Lavoie-Tremblay
authors.affiliation: Senior Advisor for Patient Engagement and the McGill Nursing Collaborative, McGill University Health Centre (MUHC), and Assistant Professor, School of Nursing, McGill University, Montreal General Hospital, Montreal, Quebec, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Connor
authors.affiliation: Post-Doctoral CIHR Fellow, Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
authors.forename: Geneviève L
authors.initials: GL
authors.lastname: Lavigne
authors.affiliation: TCAB and CSI Project Manager, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Anaïck
authors.initials: A
authors.lastname: Briand
authors.affiliation: Assistant to the Director, Quality, Patient Safety, and Performance, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Biron
authors.affiliation: Assistant to the Director of Nursing, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Sophie
authors.initials: S
authors.lastname: Baillargeon
authors.affiliation: Adjunct Professor, Universite du Quebec a Montreal, Departement de mathematiques, Montreal, Quebec, Canada.
authors.forename: Brenda
authors.initials: B
authors.lastname: MacGibbon
authors.affiliation: Healthcare Consultant, Quebec First Nations, Montreal, Quebec, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: Ringer
authors.affiliation: Research Coordinator, Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
authors.forename: Guylaine
authors.initials: G
authors.lastname: Cyr
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D000328:Adult; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration*; D055318:Evidence-Based Nursing / Q000458:organization & administration; D005260:Female; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D008297:Male; D009746:Nursing, Team / Q000458:organization & administration; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D036301:Qualitative Research; D011787:Quality of Health Care; D011792:Quebec; D012944:Social Support
keywords: Spread strategies; Transforming Care at the Bedside program