You are a Magnet® hospital, it is not just a label: Three themes that are important in Magnet® recognition or Magnet® redesignation
By Danny Van Heusden, MSN, Magnet Program Director; Kaat Siebens, PhD, MBA, CNO; Paul Van Aken, MSN; Antwerp University Hospital, Belgium, Europe.
First: Strong Leadership
Being a Magnet® hospital implies addressing the permanent challenge of focusing on outcomes and continuously improving them. Many organizations pursuing Magnet® recognition place a strong emphasis on the bottom-up aspect because they want to make the shared governance dimension visible. This while shared governance, "governance" means "management or administration", requires strong leadership in the organization. An important element we learned in this process is that there must be a strong leadership structure at the top that is data-driven. Improving outcomes in the field, and for us this is patient care and the well-being of nurses, is impossible without a good foundation with data as well as a feedback process. The latter is extremely important because good leadership is inseparably linked to good progress control and the provision of an efficient feedback process.
The feedback process can be seen as part of the bottom-up story. The question here is: how does feedback from the clinical nurse reach the top of the organization (the CNO) unfiltered? Giving the clinical nurse a voice in the organization in this area is the essence of shared governance, but this requires strong leadership. This is especially true when we are fixating on elements related to well-being in the nurse work environment. One of the gaps that we personally observe in our practice is that managers are insufficiently armed and/or have tools to give their employees feedback or possibly to correct unprofessional behavior. This is while unprofessional behavior has a major impact on the work environment of nurses. Leadership development is certainly a strategic action that belongs in Magnet® environment.
Second: The Nurse Strategic Plan is a working document, not ‘a nice to have’ on your website
In this sense, the Nurse Strategic Plan (NSP) is not just a part of the mandatory documents one must provide in the written documentation during the Magnet® application process, but a living guiding principle through the organization that everyone align with. In the (re)writing of the NSP, both the process of the development of the NSP (how are the internal and external stakeholders involved) and the coverage of the 14 forces of Magnet® by means of strategically directed actions are important. Magnet®'s roots, in particular retaining and attracting talented nurses, remains at the core of this strategy. Interventions in the organization to improve retention and attraction of nurses are now scientifically based. The key is to engage with internal stakeholders to make the right choices and priorities in improving retention and attraction of nurses. At this point we have indicated an important condition for any intervention that aims to improve: namely, the scientific basis for the interventions. Every time an idea for an improvement arises, the response should be: is there scientific evidence for this that this decision will work.
It has been our experience that this does not always happen and on the other hand nurses do accept that the Evidence Based check is done effectively with each improvement proposal. We often hear the question asked, “how can we improve our retention in the group of newly graduated nurses”. Often one need to look no further than the resources made available through American Nurses Credentialing Center (ANCC). In this example, the ANCC Practice Transition Accreditation Program (PTAP) program provides a nicely structured and evidence-based answer to this question. In this way, one can easily justify strategic actions and incorporate them into the NSP.
Third: Collaboration is a verb and takes time and resources
The Corona pandemic has undoubtedly shown that the department of nursing is not an island in the organization; rather the crossroad through which all lines of the hospital organization run. Collaboration takes time and energy. Sometimes hospital-wide projects arise in which one plays a crucial role as a department. In the Antwerp University Hospital (UZA), the example was the implementation of a completely new Electronic Medical Record. The strategy of the department must therefore be fully aligned with these large projects that do not always fall under the autonomy of the department.
We have experienced that this delays some improvement projects linked to Magnet® interventions. This is why building in some flexibility in the allocation of resources is important. What COVID-19 care has taught us is that the agility of the organization but also the agility of the individual nurse is extremely important. In itself, agility is a distinguishing feature of a Magnet® organization because we want to provide under all circumstances the highest quality care to our patients precisely with nurses who go for their jobs and the organization.
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