Nursing Excellence

 

 
Oaklawn Achieves Elite “Magnet Recognition” for Nursing Excellence     

February 1, 2010


Oaklawn Hospital shares some of the highlights from their American Nurses’ Credentialing Center’s Magnet Recognition Report. As reported previously, Oaklawn learned they had been awarded the prestigious Magnet Recognition last September. Now they have received the formal report from the commission and would like to share some of the highlights.

The first highlight was the fact the commission did NOT identify any deficiencies for Oaklawn to focus improvements. This is a remarkable finding. Along with the absence of deficiencies, ANCC identified five areas that served as exemplars. This means that Oaklawn exceeded the expectations of the elite Magnet Recognition standards.

Some comments in the report were:
· “The hallmark of Oaklawn Hospital is visionary leadership.”
· “The influence of the CNO (Chief Nursing Officer) on system and process development/implementation extends from the boardroom to the bedside to the community.”
· The strategic planning philosophy of the organization ensures that ‘no decision is made without nursing input and influence.’”
· “Oaklawn Hospital is a “unique organization” that can be counted on to meet and commonly exceed the expectations of their patients, families, and employees.”
· The descriptors of “compassionate, caring, committed, agile, collaborative, and family” were repeated many times throughout the site visit across all venues.
· There is a palpable partnership, grounded in mutual respect, between the frontline and administration.
· The hospital workforce is a solidified team that “trusts” that together all challenges will be conquered and the community will continue to be cared for with great pride and definite humility.

And the Final Quote: “This organization is an example of a 94-bed hospital that performs at the level of much larger institution (with many more resources) as a result of being able to set the vision, work as a team, innovate solution hand-in-hand with the frontline, and remain focused on outcomes.” 

                                   

September 16, 2009

At 11:02 AM, September 16, a room full of Oaklawn Hospital employees and physicians erupted in cheers and applause after hearing American Nurses Credentialing Center ‘s Gail Wolf confirm over a speaker phone to Oaklawn’s Chief Nursing Officer, Kristin Sims, that Oaklawn had, indeed, been certified as a “Magnet Hospital.” The announcement culminated a qualifying process that took nearly four-and-a-half years, and included a 2500-page written submission and a two-day on site survey. Wolf conveyed the commissioning board’s enthusiastic confirmation of Oaklawn by relaying that the vote to award was unanimous, and by stating, “it was clear to us that Magnet is in Oaklawn’s DNA.”

The “Magnet Recognition Program” was developed by the ANCC to recognize health care organizations that nurture and demonstrate nursing excellence. Applying organizations must meet stringent criteria for nursing professionalism, teamwork, and the highest standards in patient care. Nationwide there are now 352 hospitals, or approximately five percent, that have received Magnet Designation. Oaklawn is the 7th organization in Michigan to receive the honor, joining institutions such as William Beaumont of Royal Oak, Spectrum Health of Grand Rapids, and Bronson Methodist Hospital of Kalamazoo. It is the smallest hospital in Michigan to have received this award, and Wolf said she believes Oaklawn is the 2nd smallest acute care Magnet Hospital in the country.

President and CEO Rob Covert expressed great pride in receiving this honor. “As I have witnessed the thousands and thousands of hours that have gone into this “Recognition Journey,” I know how extremely deserving our Nursing Staff is of this very high honor. I’d like to give special acknowledgment to Kristin Sims, our Chief Nursing Officer, who got us started on this journey, and her co-chairs, Sara Birch and Sondra Fettes, for the incredible amount of time, leadership and enthusiasm that all three of them contributed. But true to the Magnet philosophy, this is a team award that the entire nursing staff has worked diligently to achieve, and they’ve received terrific support from all departments, as well as our Board of Directors. This is a very proud day for the entire Oaklawn family.”

Magnet can be traced to 1983 when a task force of the American Academy of Nursing studied 163 hospitals to identify and describe variables that created an environment that attracted and retained well-qualified nurses. Forty-one of those institutions were described as “Magnet” organizations because of their ability to attract and retain quality nurses. It wasn’t until 1990, however, that the ANCC was organized to offer credentialing programs and services, and they proposed the establishment of the Magnet Hospital Recognition Program for Excellence in Nursing Services. This program used the 1983 study upon which to formulate its very strict criteria for attaining this special status.

Sims, who became Chief Nursing Officer in 2004, was well aware of the Magnet Program and thought it might be something that Oaklawn should explore, but once she attended a National Magnet Convention in October of ‘04, there was no turning back. “That conference was really inspiring for me,” Sims said. “I was surrounded by thousands of nurses who all seemed to share my vision for what the nursing profession was all about, and I was totally convinced that as tough a task as the Magnet Journey would be, I knew we had the people, the organizational leadership, and the nursing expertise to be able to earn this distinction.”

After convincing the Board of Directors of the benefits of the program, Sims formed a steering committee of 15 registered nurses. This diverse group of nurses met regularly to further discuss and formulate a plan for tackling this daunting process, which would culminate with the submission of more than 2,500 pages of documentation. “Providing outstanding care is a key focus of being a Magnet hospital, but there is so much more than that,” Sims explained. “There are 14 ‘Forces of Magnetism’ that outline the program. They touch on everything from leadership structure and management models, to personnel policies, autonomy, professional development, interdisciplinary relationships, nurses as teachers and community volunteers, and quality improvement. The Magnet Program is a very defined and detailed program that took us over four years to complete, but I am totally convinced that the journey has raised our level of care significantly and made us a better organization.”

Covert confirms that the organization has benefited from the undertaking. “Not only are nurses drawn towards hospitals with Magnet Designation, but the physicians that we recruit always are impressed to learn that we are pursuing Magnet status. Additionally, I know that bond ratings are favorably influenced by the status, perhaps because a national study has shown that Magnet hospitals account for large cost savings due to improved nurse-sensitive outcomes, shorter length of stay, and avoidance of adverse events.”

“Some of our staff bought in right away,” said Sims, “but there were some who weren’t convinced it was worthwhile. But as the process unfolded and we began implementing more and more of the practices, the nurses noticed a lot of positive improvements and the support really grew. I can’t say enough about how I think it’s helped us become a better healthcare team. You still have to have great people to reap all the benefits that it can provide, but that’s never been anything on which we’ve been short.”

“Bottom line,” said Covert, “is we selected an award that would be extremely difficult to achieve, which we knew would require us to make many positive changes, and we raised our patient care outcomes and satisfactions while achieving this prestigious designation.”



Thursday, September 03, 2009

ANCC Conducts Magnet Site Visit

     On August 17 and 18, representatives of the American Nurses Credentialing Center (ANCC) did a site visit as a final evaluation of Oaklawn's application for Magnet designation.  Thank you to all who took the time to send submissions or attend the public hearing.  We appreciate your contributions to this effort very much.  We expect to hear a determination in the second half of September.  We'll keep you informed.

Tuesday, July 07, 2009

Public Notice-Magnet Recognition Program Site Visit

     Oaklawn Hospital has applied to the American Nurses Credentialing Center (ANCC) for the prestigious designation of Magnet. The Magnet designation recognizes excellence in nursing services.
Patients, family member, staff, and interested parties who would like to provide comments are encouraged to do so. Anyone may send comments via e-mail, fax, and direct mail. All phone comments to the Magnet Program Office must be followed up in writing.
     YOUR COMMENTS ARE CONFIDENTIAL AND NEVER SHARED WITH THE FACILITY. IF YOU CHOOSE, YOUR COMMENTS MAY BE ANONYMOUS, BUT MUST BE IN WRITING.To view the whole document including address, fax and phone number please click magnet_public_notice_09_ad.pdf
                                                    

Nursing Excellence at Oaklawn Hospital

In 2005, Oaklawn Hospital’s Nursing Department began using the American Nurses Credentialing Center’s (ANCC) 14 Forces of Magnetism as a roadmap to Nursing Excellence. We have had a committed group of nurses working at continuing the excellence journey.  At the beginning of our journey it was decided that the Canadian Goose and the “Goose Story” would be our hallmark.  Please take a moment to read the Goose Story and reflect on what type of culture it represents because it truly represents the culture at Oaklawn Hospital. This culture is supporting a great work and patient care environment. This is evident through our excellent patient, physician, and nursing satisfaction scores.  Click here to read "The Goose Story".

As part of our journey we decided to apply for the ANCC’s Magnet Recognition Award.  We are still in this process and will be hosting the Magnet Appraisers for a site visit later this summer.  Some of the wonderful changes that have come through this journey are: wide-spread shared governance, including ancillary departments, increased autonomy, increased focus on relationships (with patient, families, and colleagues), increased national certifications, and an ever increasing focus on best outcomes.
 

Professional Ladder

Professional Ladder refers to one of the tools that was implemented to help educate and reward our nurses for their continued Professional Development.  This Nursing Professional Ladder allows nurses to gain points for certain professional achievements such as national certifications, quality improvement initiatives, research and evidence based practice, community involvement, and many more.  Once a certain level is obtained there are monetary awards distributed on a semi-annual basis.

The unique piece to our Professional Ladder is that it is an annual process and that one must reapply and achieve points each year to get the award.  This encourages continued involvement as opposed to reaching a level and resting there.  Many nurses have participated with the Professional Ladder and enjoy the growth and experience.

Shared Leadership

Throughout Oaklawn’s Nursing Department our nurses enjoy the autonomy of making decisions about the care process they deliver through our Shared Leadership (Governance) structure.  Each nursing unit has a unit-based council chaired by a staff nurse.  These councils are charged with making unit-based decisions with three rules that apply: the decision must impact patient safety; not break any rules, regulation, policies, or laws; and they must be budget neutral or budget justified.

Through this structure nurses have realized that they do have a voice in matters throughout the organization and what they say does have an impact.  The chairs from the unit-based councils sit on an organization-wide Nursing Professional Practice Council where all councils come together to discuss organization-wide issues, news, and solutions. A staff nurse also chairs this council with the CNO as the Administrative Advisor.

As nursing has developed their shared leadership structure, they have offered support and guidance to other departments initiating shared leadership and unit-based councils within their departments.  Great things are happening.

Oaklawn’s nurses have chosen two nursing theorists on which to base their care and professional development.  The Nursing theorist that drives our nursing care is Jean Watson.  The basic premise of Ms. Watson’s theory is based on caring relationships. “The caring moment is the moment when the nurse and another person come together in such a way that an occasion for human caring is created.”  Another main focus is on self-care of the RN.  She/He needs to maintain care of self in order to provide safe and caring atmosphere for patients.

In addition to using Watson for our care delivery theorist, the nurses chose to use the Relationship Based Care professional Model of Care.   This aligns perfectly with Watson and has three key relationships: the relationship between the nurse and his/her patient and family, the nurse’s relationship with his/herself, and the relationship with peers/colleagues/community.  The nurses voting on the Professional Model of Care felt that all of these relationships were key to successful, high-quality patient care.



Patricia Benner’s Novice to Expert

Patricia Benner's Novice to Expert is the theory used to help guide our individual professional development.  This allows nurses, their peers, and supervisor to assess their progression of development on a continuum.  For more on Benner's Novice to Expert theory, click on this link: http://www.nurse.com/ce/CE556/Novice-to-Expert-Through-the-Stages-to-Success-in-Nursing/   Following is a short explanation of the various levels within the theory.  

    Novice: A novice nurse lacks previous experience, therefore rules and “book learning” are used to guide decisions.  Given the lack of prior experience a novice has difficulty with prioritization and knowing what is important and not so important in a situation.  There is high degree of focus on the self as a learner; in fact the identification with the patient is based on mostly passive observation.  Students are a good example of a novice skill level.   

    Advanced Beginner: An advanced beginner has enough experience to notice the recurrent meaningful elements encountered in patient care situations, but experience is limited.  Multi tasking is often quite difficult.  Rules and task completion are still very important.  The advanced beginner typically feels the weight of the responsibility of their position, yet is dependent on others in many situations and realizes they need others’ expertise and assistance.  It is often hard for the Advanced Beginner to put current patient situations into a larger context.  This is due to a relatively low volume of previous experiences to compare and contrast the current situation to.   

    Competent: The competent nurse has more experience than the previous levels to judge what elements of a situation are important or not.  This nurse often tries to master situations by planning carefully and striving for predictability and consistency.  A competent nurse has organizational and time management skills.  A competent nurse has more good days than bad days but will still be frustrated on occasion when the current skill level is not adequate to address the situation to the level that is needed or that they desire to achieve.

    Proficient: and expert nurses are still needed as mentors.  It usually takes about 2-3 years to reach the Competent stage.   Proficient A proficient nurse can perceive the whole situation rather than just the pieces.  What is most important is quickly grasped and this nurse has less of a task orientation and is not as dependent on pre-set goals and task lists.  A proficient nurse is more in tune with patients and families as they have learned enough to be less focused on the self than at previous levels of development.  This nurse has highly developed clinical agency.

    Expert: The expert nurse has an intuitive grasp of situations that guide practice.  This nurse will quickly see the big picture and anticipate the unexpected.   Lots of experience helps these nurses to recognize patterns that they rely on to guide practice.  They are very invested in meeting patients and family’s needs.  It takes many years of experience and a dedication to the profession to reach this level.  Some nurses never reach this level, regardless of years of experience.