For decades the Magnet status distinguishes the healthcare organizations for being an example for others in care quality and an attractive working place for nursing professionals. Aspiration to achieve this status drives healthcare innovation and improvements in operation models as well in the customer experience. The purpose of this paper is to study how practical implementation of Magnet Program influences health care industry and drives changes in the organizations.
Overview of the Model or Magnet Designation
The Magnet Program recognizes the outstanding health care institutions for quality patient care, nursing excellence and innovations in professional nursing practice. An essence of this program can be reflected in the simple statement of Karen Daley, President of American Nursing Assoiation: “Good for nurses, good for patients” (Magnet Highlights, 2012.) From its establishment, the Magnet designation has become “the gold standard” in the nursing world.
Nursing role in healthcare cannot be overrated. The nurses provide care to the patients and, moreover, they maintain the environment surrounding the healthcare delivery. That’s why it’s vital for every healthcare institution to create an organizational context that enables development, professional growth and the best performance of the nurses (Aiken, 2005.)
A Magnet program dates back to 1981, when the American Academy of Nursing commenced its study aimed at researching the factors facilitating the best nursing practices resulting in the high-quality health care. In the beginning of the 1980s, there was a big disproportion in the nursing staff labor market, resulting in nursing shortage and inadequate staffing of 80% of existing hospitals (Luzinski, 2012), that’s why the outomes of the study were very important for improving the situation in the industry. Analysis of 41 healthcare organizations with low nurses turnover and increased apabilities to attract and retain nursing professionals helped to identify the critical characteristics or factors known as “Forces of magnetism.” The “magnetic” hospitals possessed organizational structure supporting leadership in nurses, ability to attract and retain the best nurses, delegation of necessary authority and right to make decisions, a proper level of professional independence.
On the basis of that study, in 1990 the American Nursing Association initiated the Magnet Hospital Recognition Program for Excellence in Nursing Services, managed by the dediated organization - the American Nurses Credentialing Center (ANCC.) University of Washington Medical Center in Seattle was the first institution that was granted this designation. In 2002 the Magnet program went international.
The “magnetic” forces had not changed a lot over time. The best healthcare organizations recognized as “magnets” by ANCC share the excellence in the following fields: quality of nursing leadership, professional models of care, optimal organizational structure and management style, quality of care, personnel policies and development programs, continuous improvement of service quality, autonomy, consultation and resources, professional development. There are several more dimentions of nursing excellence that are valued and recognized: relationship between the hospital and the community, interdisciplinary relations, image of nursing and teaching function of the nurses (Luzinski, 2012.)
These forces or dimentions are usually grouped into five components: transformational leadership, structural empowerment, new knowledge, innovations and improvements, outstanding professional practice, and all the above mentioned results in exemplary empirical outcomes. This structure was developed in 2008.
The requirements for hospitals seeking the Magnet designation are quite high: it should have a nursing officer with Master’s degree onboard; not less than 75% of nursing managers should have baccalaureate degree; Scope and Standards for Nurse Administrators should be practically implemented. The excellence in nursing practice must be confirmed with documented evidence (Jurkovich et al., 2010.) Application for Magnet is long and time consuming, but the advantages the organizations receive exceed efforts invested.
Influence of the Magnet Program on Change in Health Care Organizations
Magnet Recognition is the highest and most prestigious award for nursing excellence the American healthcare provider can get. Acording to ANCC data, 7% of all U.S. hospitals have achieved Magnet Recognition status. This designation is a big competitive advantage and enables an organization to attract the best industry professionals.
The Magnet Recognition Program exists not only to distinguish the best hospitals but also to promote the following goals within healthcare organizations: to support continuous quality improvement; to identify and to disseminate the excellent practices in nursing.
The first vector of influence of pursuing for Magnet status is attraction and retention the best professionals. A staff turnover rate in Magnet organizations is lower than an industry average. It helps maintain continuity of experience and also helps to save money: as studies show, every 1% decrease in turnover rate saves direct costs of $250,000 and about $500,000 in indirect costs (Betbeze, 2010.) Turnover rate is strongly connected to the personnel satisfaction level. According to Karen Daley (Magnet Highlights, 2012), nurses in Magnet organizations are 18% less likely to be dissatisfied with the work and 13% less likely to experience work burnout.
What’s the reason for that difference – implementing hanges while pursuing for designation or receiving the designation itself? This is combination of reason and consequences that can be described as “snowball.” The journey to Magnet status requires that the hospital managers review the current leadership and management model and adjusted the working environment to the high Magnet standards and requirements. The Magnet status assumes that the applicant should have the environment stimulating initiative and professional growth, supportive relations between colleagues, educational and incentive programs that drive innovation and self-development. That’s why the applicants for Magnet recognition have already better organizational structure and working environment than other healthcare market players. The experts received the data evidencing “that the process of pursuing Magnet status is a transformative process that creates an environment more supportive of professional nursing practice” (Aiken et al., 2008.) It’s a change involving every aspect of work life – leadership, authorities distribution, professional relations, level of involvement in governance, etc.
The process of transformation doesn’t stop with Magnet recognition received. The seeds of transformational leadership model and continuous organizational learning result in further evolution and improvement of working environment. And the Magnet status serves as a quality mark that attracts the best candidates. So, after achieving Magnet designation, the hospitals continue to maintain “the Magnet culture” distinguished by a positive and dynamic milieu for nursing professionals. The core values of this culture are the following: integrity, empowerment, mentoring, collaboration, etc. This culture facilitates the nurses job satisfaction and retention of the “top stars” pushing down turnover rates. For example, Scottsdale Healthcare with 20% turnover rate in 2006, after being recognized as Magnet, reduced its turnover to 1.7%-1.8% in 2009 (Russel, 2010.)
The next dimention of transformation is the patient outcomes. As the numerous studies show, the patients benefit from the steps performed to obtain the Magnet recognition. According to Russel (2010), the patient mortality in Marnet organizations is about 5% lower than in their competitors. The study by Gallup conducted in 2002 estimates that in Magnet hospitals there are 7.1% fewer safety-related accidents than the industry average (Drenkard, 2010.) Also the Magnet organizations display lower complications rate (Aiken..) The factors facilitating improvement of the patient outomes are the following: reasonable workload distribution, proper education, higher engagement of nurses, lower number of errors, high-quality care, and a safer environment. According to Linda Aiken, if all the hospitals in the U.S. have Magnet-worth practices and environment, over 40,000 deaths per year could be prevented.
The next factor transforming healthcare organizations fighting for Magnet status is intellectual stimulation (Schwartz et al., 2011) and innovation. Journey for Magnet status, as nurses report, assists to grow visionary and inspiring nursing leaders; develops excellent nursing strategies and practices; promotes quality improvement and innovation, facilitates learning and discovery; and also opens the ways to achieve new, higher standards of performance, quality, patients and employees satisfaction (Drenkard, 2010.) In this environment the employees are motivated to challenge the usual, to discover new better ways, to be creative. More decision making power, more autonomy stimulates thinking and creativity. The innovative solutions can be in various areas – management, processes, are delivery. There’re some examples of innovation from the MGH practice, implemented after achieving Magnet designation: implementation of the Medication Delivery Project for Pediatrics, creation of pre-admission testing area to improve patient information, to building the Rapid Response Team assisting overloaded units, establishing a Cardiac Nursing Task Force, etc. (MGH.)
The impact of Magnet program is not limited by the mentioned dimentions. The pursue for the designation influences financial performance, partner relations, relations with community.
Summary
The way to Magnet recognition as well as obtaining the status has a great transformational impact on healthcare organizations. It transforms leadership and management approaches, improves working environment and status of nursing profession, facilitates nurses satisfaction and retention, improves relations at work, improves patient outcomes and stimulates development and innovation. Also, it has a huge positive influence on financial performance, resource efficiency and, in general, drives the development of healthcare industry as a whole. The Magnet Program has a great future in the modern world.
References:
- Aiken L.H. Improving quality through nursing (2005). Mechanic D, Rogut LB, Colby DC, et al., eds. Policy challenges in modern health care. New Brunswick, NJ: Rutgers University Press; 2005. p. 177-88.
- Aiken, L.H., Buchan, J., Ball, J. and Rafferty, A.M. (2008).Transformative impact of Magnet designation: England case study. J Clin Nurs. Dec 2008; 17(24): 3330–3337.
- Aiken, L.H., Magnet Hospitals: The Gold Standard for Nursing Care. Retrieved from http://www.fpnl.co.za/downloads/Presentations/Presentations/Prof%20Linda%20Aiken%20-%20Magnet%20Hospitals%20The%20Gold%20Standard%20of%20Nursing%20Care.pdf
- Russel, J. (2010). Journey to Magnet: Cost vs. Benefits. Nursing Economics. September-October 2010/Vol. 28/No. 5
- Schwartz, DB, Spencer, T, Wilson, B., Wood, K. (2011). Transformational leadership: implications for nursing leaders in facilities seeking magnet designation. AORN Journal (AORN J), 2011 Jun; 93 (6): 737-48.
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- Lundmark, V.A. Magnet Environments for Professional Nursing Practice. Retrieved from < http://www.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/LundmarkV_MEPNP.pdf> Accessed 22 October 2014.
- Betbeze, P. (2010). Lower mortality, higher patient satisfaction starts with turnover. HealthLeaders Media. Retrieved from http://www.healthleadersmedia.com/content/LED-253573/Lower-Mortality-Higher-Patient-Satisfaction-Starts-with-Turnover.html
- Drenkard, K. Going for the gold: The value of attaining Magnet recognition. American Nurse Today. March 2010 Vol. 5 No. 3 Retrieved from http://www.americannursetoday.com/going-for-the-gold-the-value-of-attaining-magnet-recognition/ Accessed 23 October 2014.
- MGH. Examples and narratives describing innovations in the provision of nursing care in the organization since designation as Magnet. Retrieved from http://www.mghpcs.org/pcs/magnet/documents/evidence/Re_designation_Docs/RD_3_Examples_and_narratives_describing_innovations.pdf
