Some may think Magnet recognition is just an “award” but for CVMC leadership it represents something much greater! Magnet is an external confirmation of our excellence in nursing and a statement to the fact of our commitment of this excellence to our patients and our community. In addition, the Magnet Recognition Program provides consumers with the ultimate benchmark to measure the quality of care that they can expect to receive.
For CVMC’s third designation, our Magnet document was sent to our appraiser group the first of August, 2009. After review of our document, CVMC was given the opportunity to showcase and confirm nursing excellence during our site visit on November 3rd and 4th, 2009. Led by the Magnet Captains, staff was given the opportunity to participate in several different activities over a two month period to boost excitement about the upcoming site visit.
After the site visit in November, the agonizing wait for the verification that we had indeed accomplished the goal of re-designation began. This confirmation finally came on February 11, 2010 as Catawba Valley Medical Center attained Magnet Designation for the third consecutive time.
Previous Magnet application Manuals emphasized structure and process. Although structure and process create the infrastructure for excellence, the outcomes of that infrastructure are essential to the culture of excellence and innovation.
The Magnet Components are:
- Transformational Leadership
- Structural Empowerment
- Exemplary Professional Practice
- New Knowledge, Innovations, and Improvements
- Empirical Quality Results
CVMC was able not only to meet the ANCC’s expectations for each of these components, but furthermore received multiple exemplars. Below you can read about each of the Magnet components and what exemplars CVMC was able to achieve.
To hear what Micah Wilson, BSN, RN says about Transitional Leadership, click play below.
Today’s health care environment is experiencing unprecedented, intense reformation. Unlike yesterday’s leadership requirement for stabilization and growth, today’s leaders are required to transform their organization’s values, beliefs, and behaviors. It is relatively easy to lead people where they want to go; the transformational leader must lead people to where they need to be in order to meet the demands of the future. This requires vision, influence, clinical knowledge, and a strong expertise relating to professional nursing practice. It also acknowledges that transformation may create turbulence and involve atypical approaches to solutions.
CVMC received Exemplary Practice review for describing and demonstrating the processes that enable the CNO to influence organizational changes.
“During the visit, the CNO was present at meeting on which he serves as chair, but also for which he serves as member, showing the versatility and reach of his influence. Through a participant role, it is clear that the CNO has been able to maintain direct contact with nurses, retain an appreciation for the issues they confront, communicate information to and from them, and gain their respect and support as visible, can-do leader who advocates for them and their patients.” (Quote from an appraiser review)
To hear Debra M. Martin, RN speak about Structural Empowerment, click play below.
Solid structures and processes developed by influential leadership provide an innovative environment where strong professional practice flourishes and where the mission, vision, and values come to life to achieve the outcomes believed to be important for the organization. This is accomplished through the organization’s strategic plan, structure, systems, policies, and programs. Staff need to be developed, directed, and empowered to find the best way to accomplish the organizational goals and achieve desired outcomes. This may be accomplished through a variety of structures and programs; one size does not fit all.
Once again, CVMC met the expectations and was able to attain exemplary review for two of the expectations. The exemplars we received were for:
- Describing and demonstrating how CVMC sets expectations and supports nurses at all levels who seek additional formal nursing education.
“CVMC’s professional practice model sets the expectation for advanced education.” (ANCC Appraisal quote)
- Describe and demonstrate how CVMC addresses the healthcare needs of the community by establishing partnerships.
“From Leadership to Staff, addressing healthcare needs of the community was articulated and embraced by the organization. One of many examples of community partnership that stood out was the Ryan White Clinic. Another example that stood out was the Parish Nurse Program that serves five churches in the area.” (Quote from the ANCC appraisal)
Exemplary Professional Practice
The true essence of a Magnet organization stems from exemplary professional practice within nursing. This 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 of this Component is more than the establishment of strong professional practice; it is what the professional practice can achieve.
CVMC was able to receive three exemplars in this area of the Magnet appraisal. They were:
- Describe and demonstrate how nurses develop, apply, evaluate, adapt, and modify the Professional Practice Model.
“Planning and development of the Professional Practice Model was done at the senior nursing level with periodic feedback from the direct care staff. Staff discussed that they had input on how the actual model looked and were asked by their leadership what they throughout the process. A TAG was identified to develop the ‘roll out’ plan”. (Quote from appraiser)
- Describe and demonstrate how nurse analyze data to guide decisions regarding unit and department budget formulation, implementation, monitoring, and evaluation.
“To assist in controlling expenses during economic downturns, an overtime reduction initiative was established. The goal was to involve nurses to assist with decreasing expenses related to overtime in order to preserve jobs. Staff were engaged in the initiative, could articulate how their unit was controlling overtime, specifically, and how the initiative impacts the organization. The staff clearly understood the need to reduce cost while maintaining quality. The process held each other accountable and supported the organization’s effort to reduce overtime. They repeatedly said this was a way they could assist the organization to stay viable in current economic times”. (actual appraiser quotes)
- Describe and demonstrate that nurses at all levels routinely use self-appraisal performance review and peer review, including annual goal setting, for the assurance of components and professional development.
”Clear expectations based on the practice model and accountability through the evaluation process including peer review, self appraisal, and goal-setting related to outcomes, brought the model home to every nurse in the organization. The peer review process in enculturated from direct care staff to the senior leadership”. (Appraisal quote)
New Knowledge, Innovations, and Improvements
To hear Jackie Miller, BSN, RN, NE-BC talk about how this applies to her, click play below.
Strong leadership, empowered professionals, and exemplary practice are essential building blocks for Magnet-recognized organizations, but they are not the final goals. Magnet organizations have an ethical and professional responsibility to contribute to patient care, the organization, and the profession in terms of new knowledge, innovations, and improvements. This Component includes new models of care, application of existing evidence, new evidence, and visible contributions to the science of nursing.
The exemplar CMVC was able to receive within the expectations for this component was:
- Describe and demonstrate the structures and processes used by CVMC to develop, expand, and/or advance nursing research.
The ANCC’s Magnet Appraisers were very impressed with the work that has been accomplished by the Director of Research (Dr. Rebecca Tart) and the Evidence Based Practice Council. “A phenomenal amount of development and progress in nursing research has occurred in the past 3 years. The organization has clearly embedded the necessary support and resources into the infrastructure of the organization”. (Actual appraiser quote)
Click here to listen to Betty Easter, RN, CPAN talk about Empirical Outcomes at CVMC, click play below.
Magnet recognition process used to primarily focus on structure and processes, with an assumption that good outcomes will follow. Today, having a strong structure and process are the first steps. In other words, the question for the future is not “What do you do?” or “How do you do it?” but rather, “What difference have you made?” Magnet-recognized organizations are in a unique position to become pioneers of the future and to demonstrate solutions to numerous problems inherent in our healthcare systems today.
They may do this in a variety of ways through innovative structure and various processes, and they ought to be recognized, not penalized, for their inventiveness.
One of the exemplars that CVMC received in this category is:
- Describe and demonstrate one CNO influenced organization-wide change.
“The CNO believed nurses at CVMC had good clinical ideas, but lacked experience in research and EBP process necessary to truly bring about practice change in a reliable and timely manner. As a result of the inception of the Research and EBP Program, three unit-based nursing research teams have been established, eighteen research studies have been presented and three of these have won awards at national meetings, and a study was finalist for the International Education Exchange Competition. EBP is the norm within the facility and the team approach to research and EBP projects has alleviated many of the concerns that individual nurses may have had about undertaking these opportunities for professional growth”. (Quote out of the appraisal)