Domains. Components/Domains a meaningful set of related concepts or indicators

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1 Quest for Nursing Excellence Magnet Journey Quest for Nursing Excellence Quest for Nursing Excellence Diane Hanley, MS, RN-BC, EJD Director, Nursing Education, Quality and Professional Practice St. A s Class of 79 Boston Medical Center What is Magnet? American Nurses Credentialing Center (ANCC) Certification Recognition for excellence in professional practice Performance driven recognition Measurement against very high standards Evidence-based framework Investment in nursing The History of Magnet 1980 s a significant nursing shortage. A handful of hospitals successfully weathered the shortage. 1983, a team of ANA researchers sought to discover what made them special. 41 possessed superior attributes The research team identified magnet hospitals and the attributes forces of magnetism Transformed to new Magnet Model The Forces of Magnetism Quality of Nursing Leadership Organizational Structure Management Style Personnel policies and programs Professional Model of care Quality of Care Quality Improvement Consultation and resources Autonomy Community Nurses as teachers Image of Nursing Interdisciplinary relationships Professional Development Domains Components/Domains a meaningful set of related concepts or indicators o Transformational Leadership o Structural Empowerment - Resource Utilization o Exemplary Professional Practice - professionalism, autonomy and quality o New Knowledge, Innovations and Improvements - Research o Empirical Quality Outcomes 1

2 Magnet Model Why is it important? Improved work environment Magnet Hospitals have improved patient outcomes. Magnet Hospitals lead and excel: Infection rates Mortality Falls Pressure ulcers Work environment Interdisciplinary collaboration Greater external recognition Enriched staff satisfaction and productivity Competitive marketing advantages QUEST FOR NURSING EXCELLENCE Where are organizations in terms of Magnet? But most importantly: Magnet gives you a framework from which to; talk about nursing practice celebrate the contributions of nursing create tactics to improve patient care and practice environment Magnet On the journey Gap analysis 8.8% Not in the cards right now Magnet Program Growth Approximately 8.8% of US Hospitals have achieved ANCC Magnet Recognition. 8 organizations in Massachusetts have achieved designation. The Magnet Journey Phase 1 Gap Analysis and Application Phase 2 Submission of Written Documentation & review by Magnet Appraisers Phase 3 Site Visit Phase 4 Award Decision Who s next??? 2

3 Eligibility Requirements CNO: Masters prepared, and an active participant in the hospital s governance and strategic planning and ultimately responsible for the standards of nursing practice throughout the organization 100% of nurse managers/leaders must have a degree in Nursing (BSN or MSN) ANA scope and standards for Nurse Administrators implemented throughout Must collect unit-level nurse sensitive data (NDNQI) What are the attributes of a Magnet Hospital? Magnet is a prestigious and coveted international award given to organizations that demonstrate excellence in nursing practice and high quality patient care. In Magnet hospitals, nurses are empowered and accountable for their practice patients have better outcomes and are more satisfied professional advancement is encouraged and rewarded there is greater staff involvement in decision making QUEST FOR NURSING EXCELLENCE Transformational Leadership Leadership Quality of Nurse Leadership Management Style Strong visionary, well articulated philosophy Communicates, develops others, strategic thinker Patient and staff advocate Strategically positioned and influential Quality Plan Evidence based practice Shared decision making Structural Empowerment Resource Utilization and Development Organizational Structure Personnel Policies Community Image of Nurses Professional Engagement- shared governance Professional Development Teaching and Role Development Commitment to Community Involvement Recognition of Nursing Exemplary Professional Practice Professional Models of Care Care Delivery Model Quality of Care ethics, patient safety, quality infrastructure, diversity Quality Improvement Consultation and Resources Autonomy Nurse as Teachers Interdisciplinary Relationships Culture of Safety Peer Review 3

4 New Knowledge, Innovation & Improvements Research, Innovations Quality of Care Research and EBP Nurses role in IRB Protection of patients Quality Improvement Outcomes Quality of Care Empirical Quality Outcomes Patient Outcomes Risk adjusted mortality rates Healthcare acquired infections Falls and injuries Overall Patient Satisfaction Patient satisfaction with nursing care, educational information, pain management Patient perception of safety Population specific outcomes Empirical Quality Outcomes Nurse Outcomes Level of nurse engagement, nurse satisfaction Perception of nurse autonomy Turnover and vacancy rates % direct care RNs and leaders with certifications Educational preparation of nurses Rates and types of staff injuries Staff perception of safe culture and work environment Staff perception of orientation and/or effectiveness of continuing education Empirical Quality Outcomes Organizational Outcomes Efficiency and/or elimination of waste CNO impact on system-level change Consumer Outcomes Impact of community outreach programs Community health and welfare Establishes a shared vision Demonstrates a partnership of leaders and clinical nurses Designed, implemented and advanced over time. Framework for ensuring autonomy, accountability, and peer review competence and ethical practice privacy, security, confidentiality, advocacy and diversity Interprofessional collaboration and leadership Quality care monitoring and process improvement Explicit and observable set of values and philosophies Practical methods for conducting work Leadership Strategic Direction Infrastructure and resources Self reflective Best practices Respect and collaboration 24 4

5 Every organization is unique, so. No two professional practice models are the same Practice Environment Nurse Sensitive Outcomes Nurse participation in hospital affairs Nursing foundation for quality of care Nurse manager ability, leadership, and support of nurses Staffing and resource adequacy Collegial nurse-physician relations Rates Falls CLABSI Assaults Injury Falls CAUTI Non-Magnet Magnet Magnet is Outcomes Focused! That nurse satisfaction or engagement data, nursing-sensitive indicator data, and patient satisfaction data, aggregated at the unit level outperform the mean, median, or other benchmark statistic provided by the national database used Magnet Themes Group Work Care Delivery Model- Synergy Ethics, Research & IRB Nursing Quality Plan and NDNQI -- DATA Professional Development, PRP, Certification, Education Interdisciplinary relationships Shared Governance Shared Decision Making Evaluations and Peer Review New Graduate Transitions / Experienced Nurse Patient and Family Education Safe Patient Handling Culture of Safety Bedside Handoff ED Handoff 5

6 Role of Nurse Educator 80 by 20 Professional Certification Learner Needs Assessment Outcome of Professional Development Peer Review Nursing Research Utilizing trended data to drive change Professional Organization membership Preceptor and mentorship Succession planning Patient Teaching expertise New Graduate Nurse Transition Opportunities for experienced nurses Internal experts Evidence based practice Magnet Designation It takes a village - Magnet Champions! A designation for a hospital we can t do it alone! Magnet is a Journey not a destination. 31 And enjoy the ride! The playbook If you want to build a ship, don t drum up the men to gather wood, divide the work and give orders. Instead, teach them to yearn for the vast and endless sea. Antoine de Saint-Exupery Questions? 6