1. Magnet Recognition Program Jacqueline Collavo, MA,BSN,RN,NE-BC Director, Nursing Operations and Magnet Recognition Program® April 2016 Magnet ® designated since 2006

2. Page 2 Define the initial steps of prpeparation required to pursue Magnet Designation Describe the gap analysis process in preparation of the Magnet Document Gain a global understanding of the ANCC Magnet Recognition Program Objectives

3. Page 3 The Magnet Recognition Program ® recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Consumers rely on Magnet designation as the ultimate credential for high quality nursing. Developed by ANCC, Magnet is the leading source of successful nursing practices and strategies worldwide. What is Magnet? What is Magnet ® ?

4. Page 4 Benefits of Magnet  Designation Attract and retain top talent Improve patient care, safety and satisfaction Foster a collaborative culture Advance nursing standards and practice Grow your business and financial success

5. Page 5 The Magnet Recognition Program ® advances 3 goals within health care organizations: Promote quality in a setting that supports professional practice Identify excellence in the delivery of nursing services to patients/residents Disseminate best practices in nursing services.

6. Page 6 There are currently 433 Magnet Facilities throughout the world West Penn Hospital was the first hospital in the Pittsburgh region to be recognized as Magnet in 2006, we were re-designated in 2012 and are working on our 3 rd re-designation this year

7. Page 7 The Magnet Model Focus is on OUTCOMES Prior to 2008 the focus on the application was more about structure and process After 2008 and now in the Manual (2014), the process incorporates OUTCOMES throughout the model

8. Page 8 2014 Magnet Manuel The 2014 Magnet revisions are evidence based – They are relevant to the healthcare changes that we are seeing around the world – Reduces the amount of information requested – And simplifies the document submission

9. Page 9 Eligibility Criteria A CNO who is responsible for sustaining the standards of nursing practice All areas in which the CNO is responsible must be included in the application The CNO must be an active participant within the applicant organization’s governing, decision and strategic planning process Master Degree prepared, if not a MSN then must have a BSN (this includes Interim CNO) Effective 1/1/2013 all nurse managers and leaders must have a degree in nursing (baccalaureate or graduate degree). Appointees or interim must also comply with this requirement

10. Page 10 Application Process The application serves as a statement of intent to submit your written documentation – The CNO signature indicates that the organization is in compliance with eligibility requirements The review process nonrefundable fee structure – The CNO confirms 100% of nurse managers and nurse leaders possess at least a BSN degree – The CNO allows the Magnet® program office to publish and disseminate best practices and exemplars identified in the document for the Magnet Learning communities – Documentation must be original work and reflect the uniqueness of the organization.

11. Page 11 Step 1 – Application may be submitted at any time – Applications will be processed and written documentation submission confirmed when all of the following have been received Online application Application fee – The initial application fee is $5000 Application Process

12. Page 12 Step 2 – Supporting documentation CNO Curriculum vitae of resume Organizational chart Nationally benchmarked nurse satisfaction survey tool Nurse manager and nurse leader educational eligibility tables (100% of all managers and nurse leaders must have a degree in nursing – BSN or higher) – Final verification of education will occur during the site visit – Written documents are accepted 5 times per year February, April, June, August or October and are due the first of the month– the ANCC and the organization will determine the date of document submission Application Process

13. Electronic submissions - web based format and thumb drive now required, a hard copy submission will not be accepted 12 point Arial – Maximum of five piece of evidence per example – Page limit for total document 350 pages Excluded from the page limit source of evidence for nurse satisfaction, patient satisfaction, nurse sensitive clinical indicators o Page size 8.5x 11 with 1 inch margins o Single spaced, single sided– except for preprinted documents such as brochures A hard copy of the entire documentation submission should be prepared in case the electronic file malfunctions Clearly labeled with the organization’s name, date. Document Submission

14. Page 14 Organizational Overview  Contextual information – history and population served  Transformational Leadership Overview CNO CV Org charts, strategic, quality and safety plans  Structural Empowerment Overview Policies and Procedures that guide professional education, certification, tuition reimbursement, action plan to get 80% of all RN with a BSN or graduate degree by 2020  Exemplary Professional Practice Overview A schematic of the Professional Practice Model Evidence of peer review and performance evaluation  New Knowledge, Innovations & Improvements Overview Policies that guide the IRB Research and EBP

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16. Page 16 Transformational leadership – All evidence is relative to Nursing leadership Strong vision, philosophy, strategic and quality plans which is well communicated throughout the organization The CNO is strategically positioned to influence the organization Nursing vision is aligned with the organizations’ vision

17. Page 17 Structural Empowerment – Structure is flat, flexible & decentralized – Nurse are involved in shared governance and shared decision making – Flow of information is multidirectional at all levels – Strong partnership with the community to improve patient outcomes – The organization supports continuous professional development such as certification – Clinical nurses are involved in interprofessional decision making groups such as quality, budget review, M & M

18. Exemplary Professional Practice – Professional practice model is the overarching framework for nurses and nursing practice – Care delivery is integrated with the professional practice model and promotes accountable delivery of nursing care – How nurses partner with the interdisciplinary and interprofessional team to improve patient outcomes – Competency assessment and peer review – Culture that ensures equity in care and equity in the workplace – Culture of safety and quality – Outcomes that outperform the benchmark

19. Page 19 New Knowledge and Innovation – The organization integrates evidence based practice and research into clinical and operational processes. – Nurses are on the IRB – Innovation in patient care, nursing and practice environment is hallmark of the organization

20. Page 20 Document review by appraisers Document is complete and ready to send – Each appraiser receives an electronic copy and one copy is sent to the Magnet Program office Must also send to the MPO » Copies of the nurse manager and nurse leader education tables » Table of ongoing research studies » The number of appraisers is determined by the number of licensed beds and how widespread any outpatient areas are from the main inpatient facility » You will receive the CV of the appraisers as long as no conflicts you are good to go » Typically takes 3-4 months for the review of the written document or request for additional documentation If additional documentation is needed you have 20 days to produce » Additional fees are paid 2 months before the documentation submission day based on licensed beds » payment is due 60 days after receipt of invoice

21. Page 21 Document review and Site Visit by Appraisers Acute Care In-Patient Settings and Long Term Care New applicants 1-299 $18,000 300-399 $30,000 400-499 $40,000 500-749 $49,000 750-949 $59,000 950+ $65,000 + $65 per bed over 950 Documentation Review Fee Team Leader - $2,500 Team Member - $2,000 each Site Visit Fee Daily Fee: $1,850 per appraiser All travel, hotel and per diem expenses for each Magnet appraiser are covered by the applicant.

22. Page 22 Site visit Clarify, Verify and Amplify Magnet program office analyst will assist the Magnet Appraisal Team to determine site visit dates Public notice for 30 days prior to the visit For staff and for the public The commission on Magnet recognition requires a review of any expressions of concern from any source The length of site visit is dependent on the inpatient licensed beds

23. Page 23 Prep for site visit Random selection by the appraisers for group meetings Leadership and nurse files Members of the community and schools of nursing Review of budget, nurse sensitive indicators, nurse and pt satisfaction data and advocacy department files reflecting reports related to nurses and nursing

24. Page 24 Prep for site visit Appraiser will meet with the CNO and MPD every morning to confirm agenda and address any concerns Attendance will be taken at meetings Meetings will open with introductions No planned presentations unless discussed in advance The organization should assign nurses to serve as escorts and timekeepers Will visit most if not all nursing units – Managers role is indirect, the focus is the nurse who delivers direct patient care – The appraiser generally like to visit random patients and families

25. Page 25 Phase 4 The Commission on Magnet The commission reviews the recommendations of the appraisal team Bases whether the organization has met the threshold for excellence Designation is for 4 years

26. Page 26 Document Preparation Most time-intensive part of the process 2 years + Review each SOE Group brainstorming Always involve frontline and leadership

27. Page 27 Magnet Champion Involvement Quarterly sessions Team leads Review SOE’s More brainstorming

28. Page 28 Activities to Sustain Magnet Culture Trust and engage nurses in face of change and challenge: Keep RN Satisfaction scores up Engage staff to attain/maintain staff nurse leadership in face of loss of experienced staff (CN IIIs, certified nurses, Council leaders) Empower staff nurses to keep patient satisfaction strong Support staff to maintain enthusiasm, use experience and knowledge to keep patient outcomes exceptional

29. Page 29 Activities to Sustain Magnet Culture Staff nurse sustainability: Support shared governance sustainability Support evidence-based practice and interdisciplinary collaboration and teamwork Support ongoing and encourage new nursing research Encourage and recognize professional achievements

30. Page 30 Continuing the Magnet® Journey We must remember that Magnet excellence is a continuous process – a journey – and that this journey never ends While we are extremely proud of our achievements, being a Magnet organization and a Magnet nurse carries significant professional responsibilities Magnet organizations are charged with being innovative and sharing those innovations and best practices with other nurses and organizations

31. Page 31 Continuing the Magnet® Journey As healthcare across the nation undergoes unprecedented change, the ANCC program is also changing The new Magnet manual presented new standards to meet – and exceed – for our next 2016 – Magnet redesignation This includes new challenges that are a direct result of the Institute of Medicine Report

32. Page 32 Thank you! Any questions, please feel free to call: Jacqueline Collavo MA, BSN, RN, NE-BC Director, Nursing Operations and Magnet Recognition Program® West Penn Hospital/Allegheny Health Network jcollavo1@wpahs.org