1. Section Editor(s): Stewart-Amidei, Chris

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I saw a recent advertisement touting the designation of a hospital as a center of excellence, and it prompted me to think that perhaps this was the latest in a long line of bandwagons that the medical community climbs onto to set ourselves apart from the crowd. But it made me wonder: What does it really mean to be a center of excellence?

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The term center of excellence has come to represent different things in different settings. In terms of healthcare services, center of excellence usually means that the facility offers a comprehensive, multidisciplinary approach to a specific condition. Women, children, and various ethnic or racial populations may benefit from centers of excellence as these groups are traditionally underserved and underrepresented populations. In neuroscience settings, centers of excellence have become increasingly common. For example, a hospital may be designated as a Parkinson's disease center of excellence if it provides in- and outpatient neurology and neurosurgery services along with specialized nursing care and social services for people with Parkinson's disease. In fact, many different designations for neuroscience specialty care are now available, such as Huntington's disease, autism, and multiple sclerosis. Such designations are usually offered by patientfocused organizations rather than accreditation organizations like the Joint Commission. A designation is meaningful because it may attract patients or prompt nurses and physicians to refer patients to the facility.


Designation as a center of excellence may mean that the center has chosen to focus on a particular area of research, with this distinction being given to those who make concerted progress in an area. For example, the National Institutes of Health designates facilities as centers of excellence in cancer research. Such designations may spark further innovation and also translate into increased funding for a facility. Some institutions use excellence designations as recruitment tools. A recognized benefit of Magnet status from the American Nurses Credentialing Center is the recruitment and retention of the best nurses.


Some institutions have chosen to designate themselves as centers for excellence. In this situation, "center of excellence" becomes a contemporary approach to marketing the facility's services. After all, who wouldn't want to receive care in a center of excellence? The meaning of the term is very different in this situation. It serves to clarify priority services, foster competition, and promote economic performance.


As a nurse, it is important to understand the meaning of center of excellence within its context as well as where the designation originates. It is also important to understand the related issues. Designation as a center of excellence may have an associated cost, which can defer monies away from direct patient care. In addition, high-cost, poorly reimbursed services may become a low priority, leaving some patients with limited access to care. Sharing resources is important in rare or unusual healthcare situations, which unfortunately are commonplace in the neuroscience specialty; however, centers of excellence may be less willing to share resources as they try to set themselves apart. Nurses must also be careful not to put too much meaning into excellence; a center that has designated itself as excellent doesn't necessarily offer excellent care.


While there is no doubt that being designated as a center for excellence has its benefits, we must be careful to understand the issues before we climb blindly onto the bandwagon. By being involved in obtaining excellence designations, nurses can best understand and use the designations to enhance patient care.