Magnet Recognition

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Magnet Recognition

• Its Not the Size, Its the Culture

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Katherine Riley, BSN, RN

• Director Integrated Clinical Services
• Womens and Childrens Services
• Access Services
• Social Services Magnet Coordinator

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Southwestern Vermont Medical Center

• 99 bed not for profit community hospital
• ADC of 50
• Magnet recognition in March, 2002
• 47th in the country
• 1st in Vermont
• 3rd in New England
• Smallest

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Goals of Magnet Recognition Program

• Identify excellence in the delivery of nursing
  services to patients/residents.
• Promote the quality in an environment that
  supports professional practice.
• Provide a mechanism for the dissemination of
  best practices in nursing services.

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Characteristics of Magnet Environment

• High quality patient care
• Clinical autonomy and responsibility
• Participatory decision-making
• Strong nurse leaders
• Two-way communication
• Community involvement
• Opportunity for professional development
• Effective use of staff
• High levels of job satisfaction

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Forces of Magnetism

• Elements that contribute to an organizational
  culture that permits patients to receive
  excellent care from nurses practicing in an
  excellent health care environment

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14 Forces of Magnetism

• Quality of nursing leadership
• Organizational structure
• Management style
• Personnel policies and programs
• Professional models of care
• Quality of care
• Quality improvement
• Consultation and resources

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14 Forces of Magnetism

• Autonomy
• Community and the healthcare organization
• Nurses as teachers
• Image of nursing
• Interdisciplinary relationships
• Professional development

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Quality of Nursing Leadership

• Knowledgeable
• Risk-takers
• Articulate a philosophy of nursing practice
• Provide advocacy and support for nursing staff

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Organizational Structure

• Flat
• Unit based decision making
• Decentralized
• Nursing leader serves at the executive level of
  the organization

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Management Style

• Participative
• Feedback encouraged and valued
• Effective communication with staff

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Personnel policies and programs

• Competitive salaries and benefits.
• Creative and flexible staffing models.
• Staff involvement in development of these
  policies.

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Professional models of care

• Nurses have responsibility and authority for
  provision of nursing care.
• Nurses are coordinators of care.

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Quality of Care

• Quality care is an organizational priority.
• Nurses perceive that they are providing
  high-quality care.

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Quality Improvement

• QI activities viewed as educational
• QI activities viewed as improving the quality of
  care provided

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Consultation and Resources

• Adequate human resources.
• Knowledgeable experts - advanced practice
  nurses-are available and used.

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Autonomy

• Nurses permitted and expected to practice
  autonomously.
• Independent judgement encouraged.

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Community and the Healthcare Organization

• Strong community presence.
• Outreach programs
• Hospital viewed as corporate citizen.

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Nurses as Teachers

• Nurses permitted and expected to incorporate
  teaching in all aspects of their practice.
• Nurses involved in educational activities within
  the organization and the community
• Students
• Mentoring program for staff preceptors
• Patient education program

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Image of Nursing

• Nurses viewed as integral to provision of patient
  care services.
• Nursing is considered essential and integral
  to the provision of patient care.
• Nurses effectively influence system-wide
  processes.

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Interdisciplinary relationships

• Positive
• Mutual respect
• Collaborative working relationships

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Professional development

• Emphasis on orientation, in-service education,
  continuing education, formal education, career
  development.
• Personal and professional growth and development
  valued.

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The Magnet Culture at SVMC
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Professional Nursing

• Focus on Autonomy and Empowerment
• Clinical Advancement Program
• Decentralized Nursing department
• Shared Governance Model of Professional Practice

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Clinical Advancement Program

• Developed in 1990
• Recognizes nurses for clinical excellence.
• Stimulates professional growth and development.
• Provides framework for advancing clinical
  practice.

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Clinical Advancement Program

• Criteria include
• Clinical expertise
• Certification
• Professional role development
• Formal education

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Decentralized Nursing Department

• Eliminated supervisors and head nurses/charge
  nurses.
• Staff nurse--Director--CNO/COO--CEO
• Recognized all RNs as professionals responsible
  for the management of patient care.
• Clinical Nurse Specialists on each nsg. unit

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Shared Decision Making

• Shared Governance of Professional Practice --
  1994
• Based on Tim Porter OGrady model

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Shared Governance Model of Professional Practice

• Decentralized approach to governance that gives
  nurses legitimate power and authority for
  decisions that affect
• Professional practice
• Work environment
• Professional development
• Personal Fulfillment

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Interdisciplinary Shared Decision Making Model

• 4 Interdisciplinary councils
• Leadership Council
• Education Council
• Clinical Quality Council
• Coordinating Council
• Chaired by staff

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Staffing and Scheduling

• Unit-based self scheduling models
• Eliminated Patient Acuity Systems
• -day to day, shift to shift staffing decisions
  are made by staff nurses
• Nurse-sensitive quality indicators

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Magnetic Culture

• Tuition Reimbursement
• Unit-based education budget
• Unit-based staff committees that allocate those
  
• Customer Satisfaction/Employee Empowerment Policy