 |
William Beaumont Royal Oak: Achieving Magnet Status
| What is Magnet Status? | The Magnet Recognition Program was developed by the American Nurses Credentialing Center to recognize health care organizations that provide the very best in nursing care and uphold the tradition within nursing of professional nursing practice. The program also provides a vehicle for disseminating successful practices and strategies among nursing systems.
The Magnet Recognition Program™ is based on quality indicators and standards of nursing practice as defined in the American Nurses Association's Scope and Standards for Nurse Administrators (2003). The Magnet designation process includes the appraisal of both qualitative and quantitative factors in nursing.
More information about the program: http://www.nursingworld.org/ancc/magnet.html
Val Gokenbach, Administrative Director & Chief Nurse Executive
William Beaumont Hospital Royal Oak
Beaumont Hospital in Royal Oak was recognized for its nursing excellence by the American Nurses Credentialing Center Magnet Recognition Program. It is the only hospital in Michigan and one of 100 overall to receive such recognition. These are the notes from the Q&A session answered by Val Gokenbach regarding various nursing issues at William Beaumont Hospital Royal Oak
Our facility has just submitted our documents for review to the Magnet office and we wondered if you had any unique things you did to prepare your organization for the site visit.
Yes, we had a huge campaign around the forces of magnitude. We spent significant time setting up the infrastructure to support the program, and worked with our leadership team to make sure everyone was on board and engaged in this. We worked with the Nurse Practice Council next—65 leaders (one for every unit) that go to a monthly 8-hour meeting. We set up a parallel system to [the Nurse Practice Council] because we realized that we were going to need some help for them. We had what was called a Magnet Rep. They had their own set of meetings; grass-roots people who did posters and collected all the stories that you need to submit.
We had several events to role this notion of "Magnet" out. One of the messages we tried to present was that we were going for Magnet to profile the quality of our staff. So this meant recognition for them and a thank you for the excellent service. We had round-the-clock tables set up in cafeterias, we gave away candy, we gave the magnet survey, and we showed all of the results of the magnet surveys that measured all of those forces of magnetism. We created a video with all of our nurses doing different things (through the forces of magnetism) showing examples of working together, and we also included testimonies from patients. Magnet reps met on monthly basis, the PC reps met on monthly basis and were responsible for taking talking points back to the units. We put up banners & did a big campaign with the physicians. Physicians came around to tell the nurses how wonderful this was and that they were supportive; they called it their Stanley Cup.
How do you utilize the physician champion group in the process?
Physicians and nurses work here as a team continuously, we have leadership meetings with both. We have 11 chief administrators in this organization and 9 of us are nurses. Nursing owns everything here so it makes it very easy. Everyone reports to a nurse. We are all joined at the hip.
How do you use peer requirement process?
Peer review does not have to relate to just performance issues. It also relates to process improvement—identifying issues that need to be developed. Managers and staff do hiring, and the staff had a lot of education in order to have this policy. We are a very safety conscience place and we review these issues together and make judgments. Regarding peer review with physicians, we have a very aggressive program for support and respect between physicians and nurses. We have zero tolerance for anyone yelling at anyone.
How do you set up research model?
Prior to Magnet, we had what we called the Commission for Nursing and Research, and we set it up at a Nursing Admin level. We wanted to spend a lot of time on research and education, so we rolled them together. They meet on a monthly basis. PHD nurses are there and we have 2 of them that sit on committee and CSS. We have strong affiliation with Oakland University and Wayne State University, so bring the Dean in through the Commission whenever necessary. They are gatekeepers and look at all research and make sure we do quality nursing, from which we have had a number of publications. Staff nurses were fearful of this at first and did not feel they could discuss things like these researchers could. We brought research to a level of where we used it all the time.
What was the next level of that evidence-based practice? How do you take that to the next level, from nurses reading articles to translating at bedside?
The program was rolled out everywhere. For example, we had a situation with identification of handoff issues. Nurses on the floors came to the meeting to identify handoff issues, and they found 70 different way a patient was handed off. They went back to their unit and had to identify them. We were doing faxed reports from the emergency departments, which were eliminated. Face-to-face communication is better. We also did some studies in the Psychiatric Unit regarding eliminating restraints. In Pediatrics, we did studies with numbing jelly at bedside. That way everyone gets recognized.
What is WBHRO doing with your satisfaction survey, fall rates, and other clinical data?
On a monthly basis, data is analyzed and reviewed in our active Nurse Council process with Quality leadership present and strategies are developed at the nurse practice level. We believe those who know the system make the best improvements. Physicians are also included in process when we develop plans and outcomes. We have started doing everything we do with an evidence-based focus. We are in the process of creating a unit-based Research Nurse on the floors, a nurse who is interested in doing this type of work and wants to be a liaison for outcome, research, and attend meetings. Nurses get involved through evidence-based practice and with all of the outcome issues.
What did you do regarding fall prevention and restraint use?
We did quite a bit of work on that when we went through JCAHO review. We started with a fall risk appraisal for everyone coming in through emergency room or unit. We flagged that all over chart and went as far as to use sitters, which I don’t like to do. We used new mattresses with high edges and found that it, coupled with appraisal helped--especially with the elderly. We replaced all of our mattresses and had a drop in our fall problems. We eliminated carpeting and put up rails.
What kinds of care planning successes have you had that meet Magnet criteria?
The one thing that Magnet looks for is the quality of the integration of care models; how people work together so that nothing is missed. We have our care plans that include a care manager on every floor that works with physician and staff nurses, and everyone is part of that plan. Magnet is going to look at inter-relatedness and communication. Our care planning starts on the date that the patient gets here, and we have Care Team meeting and rounds. We are establishing a medical director for every floor, which seems to be working. Magnet is not going to look at how your care plans are set up, but they are looking more for integration.
How do you pull other departments into the magnet process?
We made sure when events were for everyone. Parties for nursing staffs had parallel celebrations for others. We made sure the other departments knew that we recognized that even though this is nursing recognition, nursing cannot do things without the other departments’ support. Nursing went into the cafeteria and delivered smiley cookies to every department and thanked them. Communication was there. A magnet organization brings in more patients and is a good place to work, so it is easier to get staff.
How do you deal with mandatory overtime?
One of the beauties of being a magnet organization is that we have a 2% vacancy rate right now and a 3% turnover rate. My emergency dept is 100% full with a wait list of people who want to work here. We already have people interviewed. A Magnet organization is a good place to work and we have never had to use mandatory overtime. We just opened a brand new hospital and are busy because we have expanded and we have nurses who want to work overtime because they don't get to do that. We do not use agency nurses. We also have an in house nursing resource team that is our own pool and work for our hospital. We also have a stat nurse program, using 2 stat nurses per day to supplement staffing. Nursing staff is really supported. We do have some areas that are on call and people who work in those areas work there because they like the work.
|
|
|
|
 |
 |
LEARN MORE ABOUT
THE RESOURCES IN THIS CASE STUDY
|
|
|
|
|
EMAIL THIS PAGE
|
|
|
|
|
