The New Magnet Model: 5 Magnet Components - Crozer-Keystone Health System - PA

The New Magnet Model: 5 Magnet Components

The 14 Forces of Magnetism™ were originally identified more than 25 years ago, and they have remained stable and relevant through the years. In 2007, the ANCC developed a new Magnet Model that aligns the 14 Forces with 5 Model Components. This new model provides a fresh perspective on the Sources of Evidence and how they interact to create a work environment that supports excellence in nursing practice.

Model Components

Forces of Magnetism

1. Transform-ational Leadership

- Quality of Nursing Leadership (Force #1)

- Management Style (Force #3)

2. Structural
Empowerment

- Organizational Structure (Force #2)

- Personnel Policies and Programs (Force #4)

- Community and the Healthcare Organization (Force #10)

- Image of Nursing (Force #12)

- Professional Development (Force #14)

3. Exemplary Professional Practice

- Professional Models of Care (Force #5)

- Quality of Care: Ethics, Patient Safety and Quality Infrastructure (Force #6)

- Quality Improvement (Force #7)

- Consultation and Resources (Force #8)

- Autonomy (Force #9)

- Nurses as Teachers (Force #11)

- Interdisciplinary Relationships (Force #13)

4. New Knowledge,
Innovations and
Improvements

- Quality of Care: Research and Evidence Based Practice (Force #6)

- Quality Improvement (Force #7)

5. Empirical Quality
Outcomes

- Quality of Care (Force #6)

Core Values of Magnet

Magnet organizations are guided by the Core Values of Magnet which align with the 5 Model Components. The elements of these Core Values are outlined below along with just a few examples of Crozer-Keystone’s many achievements in each.

LEADERSHIP IS TRANSFORMATIONAL

  • Sets mission, vision, values, goals
  • Is influential within the  corporation
  • Is visible, accessible, transparent, supportive
  • Mentors future leaders
  • Builds collegial interdisciplinary relationships

Example of CKHS Achievement:

Nancy Bucher has exhibited her visionary leadership by creating the system wide position of Administrative Director of Nursing Informatics. Gail Turley’s previous experience with nursing operations, quality and professional practice and her intuitive leadership abilities have prepared her well for bringing together the clinical process with operational applications that will improve the quality of care at the bedside. Join us in welcoming Gail M. Turley, RNC-OB, MSN, NEA-BC to her new role.

STRUCTURE THAT EMPOWERS

  • Involves bedside nurses in decision-making [shared governance/decision making]
  • Encourages professional organization activity and incorporates their Evidence Based Standards into practice
  • Expects nurses to be growing professionally through continuing education, certification and/or advancing academically
  • Develops nurses as teachers, mentors, preceptors, and role models
  • Partners with the community to address healthcare needs
  • Recognizes the contribution of nurses [extends so that community recognizes contribution of nurses]

Examples of CKHS Achievements:

Shared Governance:  As members of CKHS nursing councils for practice, education and quality, bedside nurses are involved in decision making as well as development and implementation of new initiatives. Crozer’s Nurse Practice Council and Quality Council worked together to improve the assessment and documentation of—and decrease the incidence of – hospital-acquired skin breakdown. DCMH’s Nurse Practice Council improved the procedure in which physicians clarify medication order to nurses; this has reduced delays in medication administration. Taylor’s Patient and Nurse Education Council worked together to improve the educational support available to patients with the diagnosis of diabetes.

Professional Development:  More than 100 CKHS nurses are currently attending classes to earn their BSN degrees. More than 70 are currently pursuing advanced degrees in nursing.  More than 350 nurses are certified by a national nursing association.

Community Outreach:  CKHS partners with AstraZeneca and TD Bank to implement Passport to Health, a health awareness and education program that reaches more than 6,000 elementary school children in Delaware County. CKHS partners with numerous churches in the community to offer health screening through the very successful Parish Nursing program.

Recognition: CKHS recognizes the contributions of nurses through the CKHS Center for Nursing Excellence eNursing newsletter, annual report and web site. Nursing achievements are also recognized in the CKHS Journal, which is distributed to all Crozer-Keystone employees.

PROFESSIONAL PRACTICE IS EXEMPLARY

  • Implements the CKHS Patient and Family Focused Nursing Care Model
  • Engages nurses in the betterment of their environment and patient care [shared governance/decision making]
  • Promotes continuous, consistent, efficient and accountable delivery of nursing care [care delivery system]
  • Engages nurses in the staffing, scheduling and budgeting process
  • Develops collegial interdisciplinary relationships to optimize the care given to the patient and family
  • Supports nursing autonomy while expecting responsibility and accountability in return
  • Supports, develops and measures competence
  • The Nurses Code of Ethics is a standard of practice
  • Privacy, security and confidentiality are protected [Nurses Code of Ethics]
  • Healthcare needs for diverse patient populations are addressed [Nurses Code of Ethics]
  • Promotes programs that keep the work place safe and healthy for employees
  • Institutes measures to keep patients safe, such as evidence based medicine (EBM) and the Joint Commission’s Surgical Care Improvement Project (SCIP) measures
  • Involves nurses in improving core HCAHP measures to improve the quality of 

* Pain management

* Patient understands their medical condition, medications, and discharge instructions
* Respectful-courteous care [communication with nurses]

Examples of CKHS Achievements:

Nursing staffs in all CKHS hospitals have played a key role in helping the health system to achieve a striking reduction in healthcare-associated infections by implementing evidence based practice. For this period, blood stream infection (BSI) system wide was down 68 percent, ventilator associated pneumonia (VAP) decreased by 76 percent, methicillin-resistant Staphylococcus aureus (MRSA) was down 61 percent, and clostridium difficile (C. dif) decreased by 78 percent. During FY 2010, these numbers have continued to go down. Nurses have been part of system-wide multidisciplinary teams that have worked together to reduce specific infections.

Springfield Hospital received a 2009 VHA Leadership Award for Clinical Excellence in the category of Patient Safety for meeting or exceeding national performance standards for clinical care. This category recognizes hospitals that had zero cases of catheter-related bloodstream infections and ventilator-associated pneumonia cases for the most recent 12 consecutive quarters.

CKHS received the 2009 Delaware Valley Patient Safety Award for creating the “Great Catch” program, an initiative that provides a simple way for staff to report a “near- miss event” and educates surgical physicians and staff about risk reduction strategies.

Delaware County Memorial Hospital’s Home Care department was selected as one of the “2009 Home Care Elite™,” the annual compilation of the most successful home healthcare providers in the U.S.

Taylor Hospital received the American Heart Association/American Stroke Association’s Get with the Guidelines (GWTG) Bronze Performance Achievement Award for ensuring that stroke patients receive the best quality treatment that is up-to-date with nationally accepted standards and recommendations.

CKHS nurses are currently involved in three VHA Rapid Adoption Network (RAN) projects to improve several core HCAHP measures:  Communication with Nurses (Crozer), Pain Management (DCMH), and Discharge Instructions and Process (Taylor).

NEW KNOWLEDGE, IMPROVEMENT & INNOVATION

  • Support the development of nursing research and disseminate
  • Implement Evidence Based Practice – [Standards of Practice supported by EBP and Professional Standards]
  • Evaluate and implement new/ innovative or improved method of care delivery

Examples of CKHS Achievements: 

Delaware County Memorial Hospital and Crozer-Chester Medical Center earned VHA awards in 2009 for their achievements in improving sepsis care through an evidence-based process.

The CKHS Nursing Research Council held its fourth annual nursing research symposium in October 2009 in collaboration with Villanova and Widener universities.

OUTCOMES ARE MEASUREABLE

Historically, the Magnet recognition program focused on structure and process. In the new Magnet Model, having a strong structure and processes are foundational. The focus has shifted to the outcomes of these structures and processes and how they compare to benchmarks. 

Outcomes are categorized in terms of clinical outcomes related to nursing: workforce outcomes, patient and consumer outcomes, and organizational outcomes. Quantitative benchmarks are established.

CKHS uses established benchmarks such as the National Database of Quality Indicators to measure outcomes.