Hi Aladeen. A good question. It is a costly investment and many hospitals strive for the Magnet recognition and then, once they have it, find it difficult to maintain the regular assessment so, often, relinquish the status - but are happy with the fact that they can say that they did have it. The thing that I, personally, find a little sad is that Magnet status is awarded on the basis of quality care outcomes, investment in staff development, flexible working patterns, positive recruitment and retention strategies etc - but shouldn't all hospitals, NGOs, community services be striving for that as the norm?

Dear Dr Dean,

Thanks for your answer,

Totally agree with you, shouldn't all hospitals, NGOs, community services be striving for that as the norm.

Regards,

Aladeen,

Hello, I could not agree more with Dean all hospitals be should be striving to provide excellent quality care to patients regardless of Magnet. A hospital does not have to be Magnet to be great. I will give you this to think about....when hospitals turn in their Magnet document for review they are sharing their problems, without problems or issues they would never be able to complete the very rigorous process to become Magnet. It is through the problems that solutions are discovered and implemented either a QI activity, an EBP project, or a research study. The ability to solve problems and implement changes that produce sustainable positive patient outcomes is what the whole document is about. Hope this gives you some more info to help with your question.

Take Care,

Carlana

Dear Carlana,

Thanks for your answer,

In the magnet journey, hospitals don't show their problems only, but they focused on innovations and outcomes joined with their Magnet Journey such as quality of patient care, nursing excellence and innovations in professional nursing practice. Also, written documentation demonstrating qualitative and quantitative evidence regarding quality of patient care and outcomes.

Best Regards,

The benefits of making "significant investment [assuming financial] in developing a well-structured nursing department" demonstrates a commitment from administration and provides the impetus for a paradigm shift within an institution that cannot be achieved through other mechanisms. Empowering clinical nurses and fostering collaboration among all providers is well worth the effort. "shouldn't all hospitals, NGOs, community services be striving for that as the norm?" - of course they should but Magnet designation would never have come into being and would be meaningless now if institutions considered their mission, the human elements, and were implementing evidence-based practices.

Dear Cheryl,

Thanks for your answer

Regards,

Aladeen

Adding another leaf to the conversation. I'd suggest the quality and care excellence recognized by Magnet designation is only achieved by the sum of systemwide and unit based efforts. Because of this, some organizations choose to "dip their toe in the water" by recognizing existing unit based excellence and building from there.

The AACN Beacon Award for Excellence helps units identify their current level of excellence and develop a plan to sustain and improve it. The award began in critical care and has now expanded to any inpatient or ambulatory care unit. It was also designed as a cost affordable process that is usually affordable without budget adjustments.

You may want to consider the Beacon Award as part of your exploration. www.aacn.org/beaconaward

/ramon

Dear Ramon,

This is the first time I hear about the Beacon Award, so many thanks for enlightening me. I checked the website, and there is a lot of useful information on it.

Best Regards,

My experience being a "part" of attaining magnet status in a hospital was not a positive experience for me. A project I completed for a unit was used in the process but was documented deceptively and I was not allowed to view it until the award was made. The documentation stated that I used hospital colleagues to set up the process (as desired for magnet status) when none of them ever contacted me nor offered their service to it; in fact, the hospital librarian refused her service to assist with a literature search and would not even provide a convenient time for me to use the library when I was off shift. I ended up revising a program that I instituted at another hospital to complete the project (and it became quite successful in its use as it had in the previous hospital without any assistance; (I even typed the enitre program myself, as well as patient education material.) I certainly lost all respect for the process as a result and have not supported it since. The hospital intentionally hired me at the time due to my educational level, certifications, and experience and a few years later looked to have me "retire", due to my salary level, I am sure. No one will ever convince me that there is not a financial incentive involved in its use. GBH

You may want to review some of the evidence generated through studies in which the investigators have compared patient and cost outcomes between Magnet and non-Magnet facilities. The below is a selection, there is more that can be accessed through CINAHL, etc.

Magnet hospital status impact on mortality, readmission, and patient reported quality of care.

Smith, Sarah A

University of Hawai'i at Manoa 2013; Ph.D. 231 p-231 p. (1p) Publication Type: Doctoral Dissertation – research

Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures.

Lasater, Karen B.; Germack, Hayley D.; Small, Dylan S.; McHugh, Matthew D.

Policy, Politics & Nursing Practice (POLICY POLIT NURS PRACT), Nov2016; 17(4): 177-186. (10p)

Comparison of Patient Outcomes in Magnet® and Non-Magnet Hospitals.

Goode, Colleen; Blegen, Mary A.; Shin Hye Park; Vaughn, Thomas; Spetz, Joanne

Journal of Nursing Administration (J NURS ADM), Dec2011; 41(12): 517-523. (7p)

Magnet hospitals are a magnet for higher survival rates at adult trauma centers.

Evans, Tracy; Rittenhouse, Katelyn; Horst, Michael; Osler, Turner; Rogers, Amelia; Miller, Jo Ann; Martin, Christina; Mooney, Claire; Rogers, Frederick B

Journal of Trauma & Acute Care Surgery (J TRAUMA ACUTE CARE SURG), Jul2014; 77(1): 89-94. (6p)

A while back, a hospital hired me to find out what makes 'good' employees, which they identified, stay working at their hospital and what could cause them to leave. This was a large teaching hospital. One of the significant factors for the good employees was working in a hospital that was on the 'cutting edge' of innovations. In this hospital for example the radiology personnel liked being the beta site for the latest equipment. The nursing dept lacked innovation. I recommended getting magnet hospital status which was done. There is currently at least in the US a huge nursing shortage starting with no resolution yet. My prediction is those with magnet hospital status will be more likely to retain and attract nurses.

A comment/question about the @MadelaineLawrence observation. Healthy work environments that sustain excellence can exist at every level. The entire hospital system represents the macro level. Working up from there (up because the system is the foundation for excellence) each level has the ability to be excellent. Even when the larger one level it rests on has challenges.

This continues to the level at the point of care. Which could be the teams that work together for a particular time schedule. These teams have shown themselves able to achieve a degree of excellence that parallel teams, the unit/department, division and even the system itself has not achieved. It's not an all-or-nothing propostion.

Lawrence's observations seem to point in this direction. Thoughts? (including Happy New Year!)

Agreed Ramon - these awards are often based on some excellent departments shoring up the rest of the institution. Magnet etc does not mean universal excellence, at all, across the institution. The admirable aspiration is that, given an award, this will inspire the institution to do one of two things; hold up the light 'excellent practice' as a standard for all. Some will try hard and that is a positive. Other departments will resist hard and maintain their 'poor standards' under the illusion of award and status for them. That's why such awards are so draining and hard to sustain. It's then up to the institution to decide if a 'radical overhaul' of the poorer, intransigent services is required - or removal of them overall.