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Best practice
and Magnet status |
While the concept of best practice is receiving more attention across the board, seeking Magnet status has been the catalyst for many hospitals to take a closer look.
“There is absolutely a connection between best practice and seeking Magnet status,” says Rhonda Anderson, RN, MPA, FAAN, CHE, chief operating officer at Banner Good Samaritan Medical Center in Phoenix. “The inquiry that takes place within Magnet facilities is significant, and they are always striving for improvement using evidence. There’s a culture of wanting to be the best and wanting to improve and offer the best to patients and staff through evidence-based and best practices.”
There is also much sharing of practices among Magnet hospitals, says Janice Kishner, RN, MBA, MHA, chief operating officer and nurse executive at East Jefferson General Hospital in Metairie, La. “Sometimes health care has kind of a regional mindset., but there is robust sharing of information among Magnet hospitals, regardless of region.”
The Magnet Recognition Program was developed by the American Nurses Credentialing Center, a subsidiary of the American Nurses Association. The program is based on ANA’s Scope and Standards for Nurse Administrators and Magnet Hospitals Revisited: Attraction and Retention of Profes sional Nurses.
The cost of attaining Magnet status can be significant and can include a $100 manual, a $2,500 application fee, expenses for appraiser site visits — with a $1,500 daily honorarium per appraiser — and internal staff and hard costs for preparing application information and documentation. Although some hospitals implement best practice, they don’t apply for Magnet status because they don’t believe they can afford it. But most hospitals see the cost as an investment.
“Anytime you look for differentiation for your facility, there is a cost involved, and Magnet status is no different,” says Anderson, whose hospital in now seeking the designation. “But there is a return as well, and I believe with Magnet, there is an enormous return. Staff seeks you out. Patients seek you out. They know you excel.” |
“It refers to the business office, the work environment, patient care, all of the above,” Batcheller says. “They are so interrelated anyway. For example, if you have a really good work environment, high morale, and good leadership, then patient care will be better because your staff will be stable.”
Anderson offers Banner’s new pediatric tower as an example. “There is work there on evidence-based design, research on design and physical features that helps achieve outcomes and im proves patient safety, engagement, and healing. We’re incorporating design features based on research.”
However you define them, evidence-based and best practices aren’t worth much unless they’re implemented. The Seton system shares practices in nursing leadership meetings and distributes information by hard copy, e-mail, the system’s nursing intranet system, and internal nursing publications.
Members of evidence-based practice committees across the VA compare notes, McCarthy says, and a practice that is proven at one facility is ultimately implemented at all. An example is a barcode medication administration system designed and tested at one hospital, expanded regionally, and finally put in place systemwide. “The internal evaluation process for that was akin to evidence-based practice,” Rick says. “Testing proved [barcoding] resulted in significant reduction in errors or poten-tial errors.”
Work teams at Banner research and test concepts for best practices, Anderson says, and like the VA, once a facility implements a practice and obtains expected results, the practice is implemented systemwide. Practices are shared on the system’s intranet and in poster sessions at company meetings. On a broader scale, clinical organizations use journals or online capabilities for sharing practice improvement and best practices.
Sharing practices is critical in an environment of health care institutions continually striving for 100% compliance or zero defects and where there’s an emphasis on budgets. Everyone is looking for tactics that make a difference, Batcheller says. “Take an idea and adopt it and see if you get the same positive outcomes. Study what is being done differently in a successful unit, then look at how you take those procedures and apply them elsewhere to get the same results.”
“Start by understanding that the provision of health care is always evolving,” Rick says. “Create that mindset of curiosity and scientific inquiry. Help staff understand that it’s okay to ask why are we doing what we are doing, to have that dialogue. Nur sing leaders have to develop the skill to do that because it isn’t always comfortable to question what you are doing. The intent is to stretch and improve.”
Melissa Gaskill is a freelance writer.
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