Releasing Time to Care U.S. Collaborative


Releasing Time to Care (RT2C) is a bottom up, top enabled improvement program based on Lean Management principles. Focused on caregivers in hospital settings, it taps the expertise of those at the front line, allowing unit teams to identify problems, collaborate on solutions, test ideas and measure results.

As nurses and caregivers become more committed to their work through the program, they build a new culture from the ground up – one that is more democratic, rigorous, and satisfying. We know that when job satisfaction of nurses improves, so too does that of patients, fellow staff, and organizations. Together, these dynamics lead to lower cost and better care.

“The Releasing Time to Care program has given us the tools we need to empower our staff to make positive changes and improvements that benefit our patients, staff, and our organization as a whole.”

-Erin Redling RNC, Assistant Unit Manager, Silverton Health

NurseHow the collaborative started

Created in 2007 by England’s NHS Institute for Innovation and Improvement, Releasing Time to Care was adapted in 2010 to the US by CareOregon. The key to its success in scaling up was an ongoing learning collaborative, monthly check in phone calls, nurses providing the training and leadership, and a lot of patience. After all, culture change takes a long time.

RT2C rolled out in these hospitals:

Pioneer Hospitals

  • Providence Portland Medical Center
  • Oregon Health & Science University
  • Legacy Good Samaritan Medical Center
  • St. Charles Medical Center - Bend
  • Tuality Community Hospital

Also in Oregon

  • Silverton Hospital
  • Legacy Mount Hood Medical Center
  • St. Charles Health System: Redmond, Madras, Prineville hospitals
  • PeaceHealth Sacred Heart Medical Center
  • Santiam Memorial Hospital

Outside of Oregon

  • Vancouver Coastal Health Authority: Richmond and Squamish General Hospitals (British Columbia)
  • Alaska Native Medical Center (Anchorage, AK)
  • John D. Dingell VA Medical Center (Detroit, MI)
  • Santa Clara Valley Medical Center (San Jose, CA)

ImageWhy It’s Important

In most hospitals, nurses spend on average just 27-54% of their time on direct patient care. And we found out they are interrupted 70-330 times per shift. By gaining control over their environment and workflow through excellent team work and communication, nurses and other caregivers are able to increase their time with patients by at least 20%, thereby improving care and reducing cost.

RT2C provided a powerful pathway to continuous improvement and leadership. Two pioneer hospitals, OHSU and PPMC, directly correlated RT2C to their receipt of Magnet designation, the highest award of excellence in nursing care offered to just 7% of the nation’s hospitals.

  • RT2C uses visual tools to track patient falls, pressure ulcers, hospital associated infections, staff injury, and other quality measures chosen by each unit’s team.
  • RT2C equips teams to identify and eliminate interruptions, wasted steps and inefficient workflows.
  • RT2C tools enable teams to focus on patient satisfaction, increase staff satisfaction and establish accountability within their units.
  • Ultimately, RT2C helps hospitals achieve better health outcomes for patients while lowering costs, providing a structured approach to the Triple Aim.

Releasing Time to Care: Transforming Hospital Care


Deborah Eldredge, Oregon Health & Science University, talks with CareOregon's CareNews about how Releasing Time to Care is transforming patient care quality and staff satisfaction.


Releasing Time to Care: Seeing Big Results in Health Care


Nurses from participating hospitals share stories and hard numbers that illustrate the dramatic effects of implementing Releasing Time to Care.

Releasing Time to Care


Nurses from OHSU, Providence Portland Medical Center, Tuality Healthcare and St. Charles Medical Center in Bend discuss how Releasing Time to Care has reconnected them to their commitment to serve patients.

Releasing Time to Care in the news

The nurses in unit 5G at Providence Portland Medical Center were profiled in The Oregonian's article, "Oregon nurses use British technique to cut waste, improve care."

What people say about Releasing Time to Care

“Releasing Time to Care is a transformational opportunity for nursing. Health care is traveling a very rough road right now, and we have to change the way we work in this environment. Releasing Time to Care has helped us refocus on why we come to work every day. My personal belief is that if I can help make my organization the best place to be a nurse, it will be the best place of all to be a patient.” - Pam Steinke, RN, Chief Nursing Executive and Vice President for Quality, St. Charles Health System

'“Releasing Time to Care is a great tool for magnet hospitals and any others that are committed to excellence in nursing.” - Janiece Zauner, Chief Nurse Executive, Providence Seaside

“Change is difficult... but I truly saw how important and amazing RT2C is when I searched for a chair alarm frantically and without direction on another unit. It was 0600, and it took me 15 minutes to find a part of a chair alarm, despite asking three other RNs, including the charge, where I could find one. They sent me from one end of the hall to the bottoms of the piles stacked in the med room. All I could think was how this would never happen on 5G. I realized how fortunate I am to work on a unit with organization!” - Leslie Kacelek, RN

“I feel like I am part of the team.” - Environmental Services

“In 34 years of nursing, RT2C has given me the most hope for change that promotes the nurse/patient relationship.” – Staff RN

For more information please contact Barbara Kohnen at