Magnet Recognition Program Clinical Excellence in Action

Magnet Recognition Magnet Recognition is the highest recognition the American Nurses Credentialing Center grants to healthcare organizations for excellence in nursing practice. It is a hospital award.

Grounded in Research Magnet Standards of Professional Performance The Journey Magnet Quality of Leadership Organizational Structure Management Style Personnel Policies & Procedures Professional Models of Care Quality of Care Quality Improvement Consultation & Resources Autonomy Community & the Hospital Nurses as Teachers Image of Nursing Interdisciplinary Relationships Professional Development Standards of Practice for Nurse Administrators Standards of Professional Performance for Nurse Administrators In 1993, the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association, introduced a new Magnet Hospital certification process modeled after the 1980s study. The program is based upon quality indicators and standards of nursing practice as defined in the American Nurses Association’s Scope & Standards for Nurse Administrators. The Magnet designation process involves submission of written evidence addressing each of the Forces of Magnetism and an on-site review by Magnet appraisers.

Magnet Designated Facility Information Update for January 2013 Approximately 4.45% of all health care organizations in the US have achieved Magnet designation by the ANCC. The Commission on Magnet Recognition Program currently recognizes 395 healthcare organizations, as well as three in Australia, one in Singapore and one in Lebanon for their excellence in nursing service. Massachusetts General Hospital received Magnet designation in 2003 by the ANCC, the first in Massachusetts; Redesignated in 2008.

Benefits of Magnet Designation For patients… Multiple studies have shown that patient outcomes are more favorable in Magnet hospitals. They experience fewer complications, lower mortality rates & higher patient satisfaction scores. For nurses… Professional nurses consider Magnet designation as the Gold Standard when looking for a practice environment where autonomy, control over practice & professional development are emphasized. For the hospital… Magnet signifies high quality care to consumers. Many Magnet hospitals advertise through media, newspaper announcements, billboards, radio & TV commercials. The improved attraction & retention of nurses results in significant cost savings. Patients, nurses and the entire hospital community benefit from Magnet designation. Some of the most visible examples are… (review points highlighted for each group).

A New Model for ANCC’s Magnet Recognition Program ® Structural Empowerment Exemplary Professional Practice Transformational Leadership Empirical Outcomes New Knowledge Innovations & Improvement © American Nurses Credentialing Center

Transformational Leadership Organizations can no longer just try to solve problems, fix broken systems, and empower staff – they must actually transform the organization to meet the future. This requires vision, influence, clinical knowledge, and strong expertise relating to professional nursing practice. “It is relatively easy to lead people where they want to go; the transformational leader must lead people where they need to meet the demands of the future.” - ANCC

Structural Empowerment Solid structures and processes developed by leadership provide an environment where strong professional practice flourishes. It is an organization where the mission, vision and values come to life to achieve the outcomes important for the organization. Strong relationships and partnerships are developed with all kinds of community organizations to improve patient outcomes. This is accomplished through the organization’s strategic plan, structure, systems, policies and programs.

Exemplary Professional Practice • This component entails a comprehensive understanding of the role of nursing; the application of that role with patients, families, communities and the interdisciplinary team; and the application of new knowledge and evidence. The goal is more than the establishment of strong professional practice; it is what that professional practice can achieve. • Nurses are accountable for safe, ethical, evidence- based care.

Massachusetts General Hospital Professional Practice Model © MGH Patient Care Services 1996, 2006, 2012

Massachusetts General Hospital Patient Care Delivery Model Interdisciplinary, patient- and family-focused care. A philosophy of relationship-based care guides our practice, emphasizing basic tenets of the caregiver’s relationship with: • Self (self-awareness) • Team/Colleagues • Patient and Family • Environment of Care © MGH Patient Care Services 1996, 2006, 2012

New Knowledge, Innovation & Improvements • This is the nursing research component of Magnet. Healthcare organizations, which earn the Magnet designation, must show they are open to, and even developing new models of care, applying existing evidence, building new evidence, and making visible contributions to the science of nursing.

Empirical Quality Results The question the ANCC poses to organizations seeking Magnet status is not “What do you do?” or “How do you do it?” but rather a focus on “What difference have you made?” A shift from structure and process to outcomes. Healthcare organizations are expected to become pioneers of the future and to demonstrate solutions to numerous problems inherent in the health care systems today. Outcomes need to be categorized in terms of clinical outcomes related to nursing; workforce outcomes; patient and outcomes; and organizational outcomes. Key indicators that paint a picture of the organization.

Magnet Re-designation Timeline April 2010 – October 2012 Evidence collection and writing October 1, 2012 Submitted evidence to ANCC October 1, 2012 – Prepare for site visit Site visit 2013 March 4-7, 2013 Site Visit Approx. 2 months post site visit Magnet Commission Vote This timeline highlights key activities that have been completed to date as well as planning and preparation that will take place in the beginning of 2008.

Purpose of Site Visit A site visit occurs if the scores for the sources of evidence fall within a range of excellence. The purpose of the site visit is to verify, clarify, and amplify the content of the written documentation and evaluate the organizational setting in which nursing is practiced.

Site Visit – March 4-7, 2013 Appraisal Team Mary G. Nash, PhD, FAAN, FACHE - Team Leader Chief Nursing Officer and Associate Vice President for Health Sciences, Ohio State University Health System, Columbus, OH Carol “Sue” Johnson, PhD, RN, NE-BC – Team Member Director, Nursing Clinical Excellence & Research, Parkview Health, Fort Wayne, IN Linda C. Lewis, RN, MSA, NEA-BC, FACHE – Team Member Chief Nursing Officer and Vice President for Patient Care Services, Forsyth Medical Center, Winston-Salem, NC Linda Lawson, MS, RN, NEA-BC – Team Member Chief Nursing Officer, Sierra Medical Center, El Paso, TX

Staff and Public Notices: Before 1/23/13 Staff Notices: - All-user message - Mailing to MGH employees not on e-mail - Have 24/7 access to Magnet evidence (Magnet Portal Page: http://www.mghpcs.org/magnet or in Nursing Supervisor Office on Bigelow 1406D, phone 617-726-6718, pager 617-726-2000 #2-5101 Public Notices: - Hospital signage (English & Spanish) - Newspaper ads: Boston Metro, Beacon Hill Times, Charlestown Patriot, Revere Journal, Chelsea Record, Waltham News Tribune, Danvers Herald, El Mundo Boston Other: - MGH website - Caring Headlines, Fruit Street Physician, Hotline

Site Visit – Agenda Visits to patient care settings (units, clinics, health centers) Numerous meetings with MGH Staff Nurses Breakfast and luncheon meetings (randomly-selected nurses) Health Centers nurses Nursing and Organizational meetings: Hospital Senior Leadership plus representatives from MGH Board of Trustees Nursing Executive Leadership Nursing Directors Physicians Collaborative Governance committees (Ethics, Research/EBP, Informatics, all CG committees in aggregate) Champions (e.g. Magnet, Pain, etc.) Ancillary and Support Service Departments (Departments that support nursing care delivery) Additional meetings: Interdisciplinary Committees, Community, Schools of Nursing, Human Resources, Nursing Education, Patient Satisfaction, Staff Satisfaction, Peer Review and Clinical Advancement) Document review: performance evaluations for all levels of nurses, IRB minutes, staff and patient complaints, requested information about selected sources of evidence

Magnet Portal Page http://www.mghpcs.org/magnet

Characteristics of Magnet Hospitals Include: Concern for patients and families is our #1 priority Nurses identify the hospital as a supportive place to work Nursing leadership is visible and accessible Autonomous and empowered clinicians Delivery of high quality nursing care as rated by patients and staff Strong and collegial nurse-physician relationships, teamwork and communication Delivery of interdisciplinary patient- and family-centered care