Authors

  1. Pastorius, Dan

Article Content

According to the American Nurses Credentialing Center, Magnet designation recognizes the quality of your nursing program and its overall dedication to excellence. Once the Magnetic crest is emblazoned on your facility's walls and Web site, it proves a testament to your organization's willingness to provide the best quality of care possible. Here, observe some of the Women's Hospital and Georgetown University Hospital's exceptional Magnet-based characteristics.

 

Woman's Hospital, Baton Rouge, LA

Known as the "birthplace of Baton Rouge," Woman's Hospital offers its patients a "woman's touch" from the time they register to the moment they're discharged. From specialized surgical procedures to customized wellness programs to a renowned obstetrics program, the facility's mission revolves around improving the health of women and infants. Woman's Hospital is nationally known as a leader in women's and children's health, and is one of the largest women's specialty hospitals in the United States.

 

Since Woman's Hospital's inception in 1968, the 225-bed, not-for-profit organization delivers 8,100 babies and performs 7,000 surgeries, 45,000 mammograms, and 80,000 Pap tests annually. Services include prenatal and women's health education, gynecologic and general surgery, neonatal surgery, gynecologic oncology, outpatient surgery, pediatric subspecialty clinics, physical therapy, and much more. All proceeds from the operation of the hospital are reinvested in new equipment, community service programs, and expansion.

 

"Magnet status has elevated the nursing profession in the organization and fostered teamwork among all disciplines," says Patricia Johnson, RN, CNAA, BC, MSN, senior vice president/chief nurse officer (CNO)."The success of our Magnet journey is the result of all employees working together toward a common goal-excellence."

 

Quality of leadership

 

[black diamond] Woman's Hospital provides numerous programs that encourage members of the nursing staff to enhance their skills and knowledge. These programs include tuition reimbursement and career ladder. The career ladder program has been in place since 1986, demonstrating a long-standing commitment to the professional development of nurses.

 

Organizational structure

 

[black diamond] The CNO reports directly to the CEO and serves on the organization's clinical oversight committee. A prevailing decentralized, shared decision-making process throughout the organization's operations is evident and enables the organization to be responsive to changes in the healthcare environment. The organizational structure allows the CNO to influence strategic planning and operations at the highest decision-making level.

 

Personnel policies

 

[black diamond] Collaboration among nursing, finance, and human resources is evident in many policies and programs through the use of task forces or committees. A goal oriented 360-degree appraisal process links professional standards of practice and supports career development and advancement. The staffing system adapts to internal and external factors, and reflects safeguards for employee rights and a safe work environment. Nursing recruitment and retention programs involve direct care nurses.

 

Professional model of care

 

[black diamond] Because of the different specialties and types of patients at Woman's Hospital, a blend of nursing theories and models of care are utilized to best meet the needs of the patients and staff. Care delivery is planned with consideration given to regulatory as well as professional guidelines.

 

Quality of care

 

[black diamond] The infrastructure of Woman's Hospital nursing department incorporates processes that include human and material resources supportive of care delivery; systems that promote, support, monitor, and improve patient and staff safety; an integration of the ANA Code of Ethics for Nurses and Patients' Bill of Rights throughout the nursing organization; and an assimilation of research and evidence-based practice.

 

Quality improvement

 

[black diamond] Nurses are involved at all levels of the organization for quality improvement planning and processes. These include monitoring, evaluation, and improvement of nurse-sensitive quality outcomes appropriate to the clinical setting. In addition, clinical and operational indicators are benchmarked with external entities to modify care processes.

 

Management style

 

[black diamond] Woman's Hospital benefits from a participatory management style that encourages staff feedback through leaders who are committed to effective communication. An effective horizontal and vertical communication exists between the nurses of the organization. The CNO facilitates and supports decentralized, shared decision-making through the organizational nursing councils, as well as unit-based councils and committees. The CNO serves as the chairperson for the Nursing Executive Council that is responsible for coordinating and facilitating the shared governance model of nursing leadership.

 

Consultation and resources

 

[black diamond] Advanced practice nurses and other knowledgeable experts are available for peer support and consultation both within and outside the nursing division. Clinical educators are available in all patient care areas. In addition, a doctoral prepared nurse is available for consultation in the area of nursing research.

 

Autonomy

 

[black diamond] The environment within which nurses exercise autonomy includes the following: 1) a peer review process for all nurses, 2) access to appropriate literature and databases to be utilized by the nurses in the planning, provision, and evaluation of patient care, 3) standards and processes that frame and shape nursing practice, 4) credentialing and privileging processes for advanced practice nurses, and 5) compliance with national and professional nursing standards. Based on a nursing assessment, the nurse may exercise independent judgment by involving other disciplines in the patient's care.

 

Community involvement

 

[black diamond] The organization provides many community education programs. During fiscal year 2005, 323 programs were offered, reaching more than 7,000 families. Woman's Hospital nurses commit many hours to community organizations that impact the day-to-day lives of others. Nurses reported over 542 different episodes of participation in more than 20 different organizations.

 

Nurses as teachers

 

[black diamond] Nurses incorporate teaching into all aspects of their practice by instructing patients and serving as mentors and preceptors to new nurses, nursing students, and others with less clinical expertise.

 

Image of nursing

 

[black diamond] Nurses are nominated by nursing leadership and peers for various awards. These nominations and awards are featured in various publications. In 2006, three nurses were recognized at the state level with awards for Mentor of the Year, Nurse Administrator of the Year, and Outstanding Community Achievement. Nurses are also featured in advertisements, television interviews, and various other media.

 

Collegial relationships

 

[black diamond] Interdisciplinary decision-making is supported by collaborative mechanisms that are evident in the formulation and approval of clinical care policies, standards of care, and/or guidelines. Multidisciplinary task forces are utilized whenever possible to develop policies, procedures, or performance improvement.

 

Professional development

 

[black diamond] Value is placed on personal and professional growth and development through orientation, in-service education, continuing education, formal education, and career development. Adequate fiscal and human resources are allocated for professional development, clinical competence, leadership capability, and professional certification.

 

Georgetown University Hospital, Washington, DC

Founded in 1898, Georgetown University Hospital's (GUH) goal is to promote quality healthcare through education, research, and patient sensitivity. These qualities reflect the facility's Jesuit heritage and philosophy of service to others. GUH is a 609-licensed bed, 1,100-physician facility that's nationally and internationally renowned as a major academic teaching hospital. GUH is the first hospital in Washington, D.C., to attain Magnet Recognition by the American Nurses Credentialing Center.

 

With a vision of being a trusted leader in caring for people and advancing health, GUH incorporates values such as integrity, respect, innovation, teamwork, and trust into its everyday operations. Specialty areas in which the facility has been ranked include neurosciences, gastroenterology, gynecology, orthopedics, and urology. Its Transplant Institute is ranked among the best in the mid-Atlantic region for liver transplant outcomes, and its neurosciences department is the first on the East Coast and sixth in the nation to offer CyberKnife stereotactic radiosurgery treatment.

 

"My involvement as CNO with the staff nurses and managers at GUH in achieving Magnet status was one of the greatest professional accomplishments of my career," says Joyce Johnson, RN, PhD, FAAN, CNO at GUH. The environment created by combining the GUH culture with the Magnet spirit is unsurpassed in enhancing and supporting excellence in nursing practice and the best possible patient care."

 

Quality of leadership

 

[black diamond] Nursing leadership at GUH is supportive and extremely visible. The CNO can be found on the patient care units and in the hallways daily. She also serves as chief operating officer, and her nursing background and priorities ensure that the needs of patients and nurses are always smoothly met.

 

Organizational structure

 

[black diamond] GUH has a flat organizational structure in which unit-based decision making prevails. Nursing departments are decentralized and nursing representation, at both the managerial and staff level, is evident in institutional committee structure. Each nurse has an opportunity to serve on a unit level or divisional level nursing council representing his or her area. Councils make decisions related to practice issues and nurses are empowered to improve nursing care through evidence-based nursing practice.

 

Management style

 

[black diamond] The CNO is accessible and encourages all nurses to freely communicate with her, either through formal appointments or ad hoc meetings in the corridor or in her office. There's an open-door policy at GUH, which enables nurses to approach their managers and the CNO at any time to discuss any concern. Participative management style is a part of the culture at GUH, as seen through our Shared Governance Structure.

 

Personnel policies

 

[black diamond] Personnel policies are created with staff involvement, and programs support professional nursing practice, work balance, and quality care delivery. Rotating shifts are minimized and self scheduling is used to promote staff input into the schedule while recognizing the need of the patients and the department. GUH has recently integrated "Click2Pick," a Web-based program that allows employees to request to work open shifts. Recognition programs exist to reward direct care nurses who show evidence of leadership in professional practice. In an effort to improve our nursing environment, our CNO meets with all nurses who have resigned to discuss the reasons for their decision.

 

Professional model of care

 

[black diamond] GUH developed a formalized model of patient care-the Caring Model. The model puts into words and concepts the approach to nursing that's been widely practiced at GUH for many years. Like all aspects of our evidence-based practice, the model is founded on several different extensively referenced models/theories, and is a roadmap to guide our nurses in their decision making.

 

Quality of care

 

[black diamond] GUH nurses are extremely proud of the quality of care provided by the division of nursing. Administration is continually supportive in providing human and material resources needed for providing outstanding patient care outcomes.

 

Quality improvement

 

[black diamond] All unit and hospital nursing Performance Improvement and Research Councils at GUH are actively involved in quality improvement activities. Each unit is responsible for improving at least 10 nursing quality indicators. Currently, 12 projects have been approved or are in development for IRB review.

 

Consultation and resources

 

[black diamond] GUH employs nearly 50 advanced practice nurses, who serve as resources internally, as well as to the community. Substantial resources are available to staff nurses wishing to attend, present posters, or speak at national conferences.

 

Autonomy

 

[black diamond] Nurses are empowered and expected to work autonomously at GUH. They are supported by management and administration in assuming responsibility and accountability for their practice. GUH ensures this autonomy with an extensive orientation program that emphasizes the national professional nursing standards. Direct care nurses are involved in changing practice to improve patient care.

 

Community involvement

 

[black diamond] GUH nurses take very seriously the facility's Jesuit heritage to help sustain its culture of service to others. GUH nurses are visible in numerous community service efforts. Through our Magnet champions, many activities are developed and implemented. GUH nurses partner with NBC4 for many philanthropic endeavors.

 

Nurses as teachers

 

[black diamond] Nurses at all levels at GUH function as teachers within both the organization and the community. There are nurse educators at the unit level, nurses in faculty roles, and nurses who are involved in presentations at either the local, regional, or national level. There are also many nurses who are mentors and preceptors to new graduates and nursing students.

 

Image of nursing

 

[black diamond] Nurses are highly regarded and respected by all the disciplines at GUH, as well as in the community they serve. Their clinical and organizational expertise is sought out at every level. The division of nursing is queried daily by hospitals across the country on clinical and organizational issues. As part of GUH's strategic plan, nurses assume leadership in confronting the challenges of the next 5 years.

 

Interdisciplinary relationships

 

[black diamond] All clinical disciplines work together in an environment of mutual respect when assessing, developing, implementing, and evaluating the patient plan of care. Frequent clinical rounds have increased collaboration throughout our institution. There are multidisciplinary meetings and committees where many nurses assume a leadership role.

 

Professional development

 

[black diamond] GUH is committed and dedicated to the continued education of its Magnet nurses. This is facilitated through financial support, allocation of time, and the opportunity to attend educational offerings. GUH offers tuition assistance for continuing education and a generous scholarship program for full-time nurses. From the clinical to administrative level, nurses are encouraged to pursue professional certification and are provided benefits and financial support for doing so. GUH nurses also have library access, as well as access to numerous online educational sites.