Initiated Magnet® activities at Lovisenberg Diakonale Hospital

By ​Monica Bukkøy Kjetland, Lovisenberg Diaconal Hospital, Oslo, Norway

​After areas for improvement had been identified from the gap analysis, it was difficult to know exactly where to start. At several of the learning collaborative meetings, there was talk about the importance of starting to eat the elephant at one end, a piece of advice we have really taken to heart, even though it is not always so easy to achieve in practice.
 
We identified a lack of a systematic competence program for the nursing service early on as an area of ​​improvement we wanted to address. After discussions with our twin hospital, Mid Coast Hospital, we were advised to start a pilot in one or two units with this as a theme. We followed this advice, and believe that this really set in motion a good process for the preparation of action plans and the start-up of other improvement work.
 
When we were to start with the pilot, we prepared a introduction course for those who were to participate in the project groups from each unit. We thought it was crucial that the project groups (consisting of the managers, assistant manager, nurse educators and at least one clinical nurse from each unit) got a thorough introduction to the history behind the Magnet concept and the Magnet principles. As work with systematic improvement work is both a key area in Magnet and a focus area at our hospital (in recent years), it was natural that the introduction course also dealt with how the project with the pilot could be carried out as a systematic improvement work.

If we - based on the Magnet principles - are to bring about a cultural change in the organization, we need to get a "ball rolling". If we in the M4E project group are to be involved in all improvement projects, the process will be too slow. We therefore decided to offer an introductory course in Magnet for all managers throughout the hospital together with resource persons, where they, based on their own identified issues, will carry out an improvement project where the Magnet principles (which they learn about in the course) are included in the work process. Together with the steering group, it has been decided that all units in the hospital will during 2022 have completed at least one improvement project where the Magnet principles are used in the work ("Magnet project").


So far, 20 units have participated in the introductory course and at least 13 "Magnet projects" are starting up. Below is an overview of the themes for the started projects, divided by departments.

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Center for Mental Health and Substance Abuse 

• The violence and threat project (at department level) uses the Magnet principles in the project work in different ways
• 2A works to strengthen the team leader role by mapping competence needs to be safe as a team leader
• 2B is working on a project related to training and handling of mechanical coercive measures
• 4A has initiated a number of change processes related to employee competence, participation in supervision, feedback culture and implementation of board meetings

 
Surgical department

• The operations department is working on a project related to the team work climate in the "outdoor living rooms"
• Post 10 has carried out a project related to standardization of discharge interviews with patients

 
 Medical department 

• The three inpatient units are in the start-up phase of a project related to reduction of workload and turnover. Has been granted increased resources for basic staffing and educational positions for nurses from April this year
• Post 7 has carried out a project related to employee safety in emergency situations and is now in the process of testing a mentoring program for newly hired nurses
• Post 6 has started a project related to structured treatment plans
• Post 8 is in the process of improving work related to workflow and workload
• Hospice is working on a project related to quality assurance, interaction and workflow

 
Other ongoing projects related to M4E

•  A PhD project will be carried out that deals with health literacy
• A project description must be prepared for an intended project that deals with involvement and well-being among physicans
• Work has begun on developing a systematic competence process for nurses, with a plan to expand to other occupational groups over time.