February 1, 2023/Global Medicine

Cleveland Clinic Supports British Healthcare System as Part of Magnet4Europe Initiative

Nursing leaders share knowledge, ideas and experience


The Magnet4Europe initiative launched in January 2020 to improve the mental health and wellbeing of healthcare professionals in Europe. A key component of the four-year initiative is a twinning relationship between a U.S. Magnet-accredited hospital and a European hospital aspiring to improve their work environment by implementing Magnet principles. Cleveland Clinic is one of 67 U.S. partner hospitals.


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“We brand ourselves as a leader in nursing, so when the opportunity to participate in Magnet4Europe arose, we wanted to be at the table,” says Nancy M. Albert, PhD, CCNS, CHFN, CCRN, NE-BC, FAHA, FCCM, FHFSA, FAAN, ACNO of the Office of Nursing Research and Innovation. “Magnet is about nurse professionalism. If you have the highest level of nurse professionalism in your hospital, then you elevate patient outcomes and nurse satisfaction. We knew we could lend our support, knowledge and experience to a European hospital.”

Albert and Monica Weber, MSN, RN, CNS-BC, senior director of professional practice in Cleveland Clinic’s Nursing Institute, work hand-in-hand with colleagues from Frimley Health NHS Foundation Trust in England, Cleveland Clinic’s Magnet4Europe partner. Frimley Health is a large health system within the National Health Service with three hospitals and 2,400 registered nurses providing care to several communities outside of London.

Weber leads the twinning relationship, while Albert oversees the second key element of the initiative, a concurrent research study on the mental health and wellbeing of the nurse and physician workforce and the value of positive work environments for wellbeing. (The research study will be featured in a follow-up ConsultQD article in the spring.)

Gap analysis reveals two target areas

Magnet4Europe scheduled an in-person kickoff event on March 16, 2020, but many hospitals – including Cleveland Clinic – were unable to attend as COVID-19 intensified around the world. Though the pandemic delayed the initiative, it did not derail it. Albert and Weber met their peers from Frimley Health in late 2020 and began working together in earnest in 2021.

One of the first tasks undertaken by Frimley Health was a gap analysis.

“Completing the gap analysis gave us the opportunity to stop and focus on nursing across Frimley Health,” says Deirdre Carter, RN, Trust Shared Governance Lead and a leader in the Magnet4Europe project at the healthcare system. “It showed us many areas within nursing that we can be proud of and allowed us the opportunity to focus on other areas we would like to work on.”

After sharing the results of the gap analysis with Weber and Albert, the team at Frimley Health selected two key areas to address – development of a nursing strategy and a shared governance structure. Cleveland Clinic has supported these goals and offered guidance during monthly Magnet4Europe Steering Committee videoconference meetings with Frimley Health, as well as an in-person meeting in May 2022.


Development of a nursing strategy

Frimley Health’s head of corporate nursing is spearheading development of the nursing strategy. She organized focus groups to help devise a strategy that reflects nursing across the health system. The groups identified six themes for nursing to prioritize:

  1. Care outcomes and fundamental and better care
  2. Framework for professional practice
  3. Celebrating success
  4. Leadership
  5. Career development and pathways
  6. Health, wellbeing and inclusion

Steering committee meetings in 2022 were devoted to each of the priorities. Applicable leaders from Cleveland Clinic joined Albert and Weber on the videoconference meetings to share the health system’s efforts in that area.

During one meeting, representatives from the Nursing Professional Development Council led a presentation and question-and-answer session on nursing recognition programs, such as The DAISY Award® for Extraordinary Nursing and Cleveland Clinic’s Nursing Excellence Awards. The information will help Frimley Health achieve its goal to implement a nurse recognition program in alignment with its priority to celebrate success.

“Plans are underway to implement the DAISY Awards as part of our new Nursing Reward and Recognition Council,” says Carter. “Hopefully, we will have our first DAISY recipient for International Nurses Day in May.”

Establishing shared governance

Frimley Health’s second focus point on developing shared governance is equally important.

“When you talk about Magnet, shared governance is foundational,” says Weber. “Frimley Health received feedback from its nurses and promoted two- way communication in a variety of ways, but it didn’t have shared governance as a decision-making body.”

The British healthcare system developed a shared governance structure, which was agreed upon by the Magnet Steering Committee in March 2022. The model supports Frimley Health’s nursing strategy by adopting councils related to each of the six priority themes. The councils created as of January 2023 are:

  • Magnet Council – To educate, motivate and promote the staffs’ understanding of Magnet; to develop strategies to maintain Magnet momentum while undertaking the Magnet4Europe research study; and to provide feedback on survey results to the nurses in their areas of work.
  • Fundamental and Better Care Council – To develop a meaningful ward accreditation program across the organization that will standardize care and encompass a culture of continuous quality improvement.

Frimley Health will continue to roll out nursing councils throughout 2023, including a nurse-led Research Council.

“Cleveland Clinic’s support with the development of the shared governance model has been superb,” says Carter. “Their advice and direction are invaluable, and they always steer us back on track when we veer off course. For example, when we were discussing the Leadership Council, we were in danger of developing a very ‘senior meeting’ rather than abiding by shared governance principles.”

Translating ideas across the pond

One of the keys to a successful relationship with the twin healthcare system is to not overstep the advisor role, says Weber.

“We provide ideas and lend support based on our experiences,” she says. “But we try to make it clear that the things we do might not be right for them, and they should adopt what they want.”

The approach is working. “Nancy and Monica’s support has been priceless,” says Carter. “They have afforded us time to reflect and develop improvements in nursing that will, in time, translate to an overall improvement in nurses’ wellbeing and ultimately the care we provide to our patients.”

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