COMMUNITY TEACHING HOSPITAL REINVIGORATES ITS CULTURE AND RENEWS ITS COMMITMENT TO EXCELLENCE

A Cultures of Excellence Story of Impact

BACKGROUND
U.S. Hospitals have made significant investments during the last decade in achieving distinction through national recognition programs including Baldridge®, Magnet®, Planetree, and others. Emphasis on exceeding national benchmarks in quality, safety, engagement, and experience help hospitals stand out. Recruitment and retention of a strong nursing and clinical workforce continues to be a top strategic priority for healthcare leaders. You can understand why when you consider that RN labor costs make up 25.5% of a hospitals budget.

One of the most valued recognition of distinction, when it comes to recruitment and retention of nursing, is Magnet® designation. Just under 10% of hospitals have achieved Magnet®. Significantly, many hospitals see this designation as a key to their future success and survival. While many hospitals have made progress, only a fraction of those who pursue Magnet® is successful. Re-designation, which must happen every 4 years, is similarly difficult to achieve.

It turns out sustaining excellence is trickier than achieving it in the first place. This is a story of one such hospital’s experience. By deconstructing their journey, you will gain insight into the critical ingredients of a culture of continuing excellence. This 300-bed community teaching hospital had received designations, including Planetree Designated® Patient-Centered Hospital, and Magnet® designation as well as the construction of a brand-new hospital building. Yet, the challenge was sustaining excellence over time. Sustainment turned out to be their Achilles heel.

MAGNET®, Magnet Recognition Program®, ANCC®, Magnet®, and the Magnet Journey® have registered trademarks of the American Nurses Credentialing Center. The products and services of Creative Health Care Management are neither sponsored nor endorsed by ANCC. All Rights Reserved.

SOLUTION
How an organization re-thought their excellence sustainment strategy. At the beginning of the partnership, there were challenges in required measures including patient satisfaction, RN satisfaction, and clinical NSIs. The prior failed attempts at re-designation was so paralyzing that it was important to formally acknowledge them through a “wake and burial” to move on and gain a fresh start. The realization that there was no “quick fix” set in and the work began. Some of the work included the following:

CHALLENGE
Achieving excellence is the beginning of a never-ending, increasingly more difficult journey.
Indeed, standing still is the quickest way to slip back. This organization found maintaining and sustaining excellence was a lot more challenging than achieving it, to begin with. Notably, after achieving leading positions across numerous benchmarks, they lost their momentum. As a result, they failed to achieve re-designation of Magnet® – not once, but twice. Underlying these failed attempts to regain Magnet®  designation was an eroding morale, weakening leadership and growing disengagement. Rather than risk a failed 3rd attempt, the organization decided to enlist support in the form of culture of excellence journey experts.

OUTCOME
A deep cultural change and organizational transformation had occurred. At the site visit, the ANCC appraisal team verified, clarified and amplified the work the organization had done and continued to do. The pride and engagement were palpable among not just clinical nurses, but all employees and leadership as well. The improvements were obvious to all involved. These improvements were reflected by their outcomes data that met the Magnet® requirement of exceeding the national benchmark in the majority the units, the majority of the time in patient satisfaction, RN satisfaction and Nurse-Sensitive Indicators (NSIs). CHCM clients find that the money invested in the journey consultation more than pays for itself in time, money, and by eliminating frustrations.

LESSONS LEARNED
You can reduce the time and cost to achieve your goals with a laser focus on key elements of your
journey.
Guidance on what and how to direct your attention can accelerate your journey. This organization benefited by partnering with a Culture of Excellence expert who quickly builds a partnership relationship and enhances the creation of high-impact interventions.
Step-by-step support to bolster shared governance
• Progressive professional practice strategy
• Structures developed to ensure clinical nurses had a voice
• Created structures and processes that fostered staff ownership of data
• Roll out and education of PPM for all staff
• Customized training and development for the new-to-the-job Magnet® Program Director
• Magnet® Program Director and document writing team mentorship
It is critical to have a journey partner, no matter how many times you have had a successful journey in the
past, to maximize your potential for success.