1. Lal, M. Maureen DNP, RN


When the coronavirus hit the United States earlier this year, hospitals across the country were forced to quickly convert to crisis mode. Overnight, health systems transformed clinical and administrative operations to care for rising numbers of COVID-19 patients. Now, as the country slowly reopens and we move back to "normal," hospitals again face a major reboot to regroup and recover. Those that meet this challenge successfully will survive. Many others will not. This month's Magnet(R) Perspectives column examines how Magnet hospitals are uniquely positioned to ride the waves and manage the chaos. What are the components that helped them adapt and adjust when COVID-19 struck, and how are those elements facilitating response and recovery? The column also looks at how the Magnet Recognition Program(R) itself responded to challenges posed by the coronavirus and altered some of its long-standing processes to meet customer needs.


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The pace of change in healthcare was already extreme when the coronavirus shifted it into overdrive. Suddenly, hospitals found themselves navigating a whole new landscape. Emergency rooms were filled to capacity, protective equipment was in short supply, and clinicians on the front lines were risking their lives to care for patients. Systems were rapidly redesigned to meet unprecedented needs.

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Whereas many hospitals struggled to adjust, Magnet(R) organizations were better positioned and better equipped to cope with the challenges. These organizations had the framework in place to successfully adopt change to drive organizational success. An environment steeped in transformational leadership, strong interprofessional teams, shared governance, empowered nurses, high RN satisfaction, transparency, and trust made these health systems more nimble in times of change.


Embracing Volatility

At Magnet organizations, nursing leaders and their teams are well versed in change management.1 They embrace volatility, routinely adapting to shifting technology, evolving care models, new payment systems, and regulatory changes.2 The Magnet framework, based on the Donabedian model3 of structure, process, and outcomes, is reflected in the components of the Magnet model4:


* Transformational leadership is a key driver of change. Transformational leaders foster a culture of accountability, which contributes to improved nurse satisfaction and autonomy.


* Structural empowerment ensures nurses at all levels are involved in decision making, which promotes trust. An environment of trust breeds cohesion and high morale. Team members feel comfortable speaking up and sharing ideas.


* Exemplary professional practice promotes effective and efficient care services, interprofessional collaboration, and the delivery of safe, evidence-based care.


* New knowledge, innovations, and improvements are the result of transformational leadership, empowering structures and processes, and exemplary professional practice.



These components enabled Magnet hospitals to effectively transition to crisis mode. Now that we have entered recovery mode, Magnet organizations can use what they have built to shift gears and embrace the new normal. The framework also positions hospitals to remain ready for the possibility of a COVID-19 resurgence, as well as another difficult flu season later this year.


Leading by Example

As the world's only nursing organization to achieve ISO 9001:2015 certification, American Nurses Credentialing Center has its own framework of structure, process, and outcomes in place that ensures we provide the highest quality of service and stay accountable to those we credentialed. International Organization for Standardization certification is the firmly established global standard for assuring stakeholders of an organization's ability to satisfy quality-related requirements. It enabled American Nurses Credentialing Center Magnet Recognition Program to quickly respond to the COVID-19 outbreak with accommodations for our customers.


We worked with the Commission on Magnet to ease the burden on organizations applying for Magnet designation and redesignation during the pandemic. Changes included extending deadlines, relaxing data requirements, and making all site visits virtual.


Preparing for the Unknowable

The coronavirus pandemic has caused all of us to change in unexpected ways. How we cope with these changes offers a unique lens on a common journey. Healthcare systems are thinking hard about the sequel: Will the virus resurge? What does "normal" look like? How can we rise up to meet it?


Nobody knows what the future holds, but we want to be ready for whatever comes our way. The Magnet framework offers healthcare organizations a potent tool in the toolbox to succeed in a lasting, changed landscape.




1. Anderson VL, Johnston ANB, Massey D, Bamford-Wade A. Impact of magnet hospital designation on nursing culture: an integrative review. Contemp Nurse. 2018;54(4-5):483-510. doi:. [Context Link]


2. Girard AS, Moreno J. Inspiring an evidence-based methodology through a practice change checklist. 2018. Accessed June 7, 2020. [Context Link]


3. Accessed June 7, 2020. [Context Link]


4. 2019 Magnet(R) Application Manual. Silver Spring, MD: American Nurses Credentialing Center. [Context Link]