The journey to achieve Magnet® designation is long and demanding. It requires nurses to analyze gaps in their current performance, develop plans to improve, and create and sustain a culture of excellence that’s supported by a robust infrastructure.
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When Nancy DeWalt, MSN, RN, NE-BC, Magnet program manager at Cleveland Clinic Hillcrest Hospital, talks about the designation, she borrows words from President John F. Kennedy’s 1962 moon speech. “We do Magnet not because it’s easy, but because it’s hard,” says DeWalt. “And because it’s hard, it makes us better.”
Six hospitals in the Cleveland Clinic Health System (CCHS) have earned Magnet recognition: Main Campus, Akron General, Fairview, Hillcrest, South Pointe and Cleveland Clinic Abu Dhabi. Several others are on the Journey to Magnet Recognition®. They are supported by a CCHS Magnet Team led by Monica Weber, MSN, RN, CNS-BC, FAHA, director of nursing professional practice, and a Magnet program director at each hospital. But much of the hard work is done by a group of select clinical nurses called Magnet ambassadors at main campus and Magnet champions at regional hospitals.
“Magnet ambassadors are registered nurses who are leaders among their peers,” says Weber. “They are enthusiastic about sustaining a Magnet culture and promoting nursing excellence at Cleveland Clinic.”
The role of ambassadors and champions
While each hospital uses ambassadors and champions a bit differently depending on its size and individual needs, the basic responsibilities of the role are the same:
- Understand the Magnet goals and process
- Promote the Magnet recognition program, professional practice and professional certification to nursing colleagues
- Disseminate information to nursing peers, and educate them on action plans to achieve Magnet designation
Most Cleveland Clinic hospitals have one or two nurses representing each inpatient and ambulatory unit as an ambassador or champion. Main campus also has ambassadors from each family health center in Northeast Ohio.
Ambassador and champion meetings are an important venue to attain knowledge and share ideas. Main campus takes a phased approach to meetings: The ambassadors met quarterly in 2020, will meet bimonthly in 2021 and will meet monthly in 2022, the year the facility submits documents for re-designation.
“We spent 2020 reviewing the Magnet components, and in 2021 we will be more interactive,” says Weber. For instance, during the fall meeting, Weber discussed Magnet requirements surrounding New Knowledge, Innovations & Improvements (NK documentation) and highlighted Cleveland Clinic programs that support nursing research. Then, Karen Schaedlich, MSN, RN, innovation coordinator in the Office of Nursing Research & Innovation, talked about the importance of nursing innovations and shared one example, the High-Line™ tool for keeping long Iines of IV tubing off the floor.
This year, the ambassadors will focus on taking what they learn at meetings back to their units and asking staff for examples of how the units exemplify Magnet criteria related to New Knowledge, Exemplary Professional Practice (EP documentation), Structural Empowerment (SE documentation) and Transformational Leadership (TL documentation).
Putting principles into action
Sharing information with units in order to transform culture and practice is key. DeWalt credits Hillcrest’s original Magnet designation in 2014, redesignation in 2019 and continued commitment to nursing excellence to the hospital’s 36 Magnet champions. “They have established the Magnet culture,” she says. “They are phenomenal!”
There are many examples of the dedication of the Magnet champions at Hillcrest. When the Nursing Institute refreshed its Professional Practice Model (PPM), they created new huddle boards to reflect the updates and ensure that the PPM principles were integrated into patient care. The champions also created bulletin boards on each unit to display data from Press Ganey’s National Database of Nursing Quality Indicators® (NDNQI) and to promote clinical nurses’ understanding of the data.
When scores are low, the champions intercede. For instance, patient satisfaction scores indicated that OR nurses were viewed as unfriendly. The Magnet champion on the unit discussed the scores, and the nurses committed to establishing a conversation with each patient. “The OR nurses turned it around and were among the best in the building in patient satisfaction after the Magnet champions explained the situation,” says DeWalt. “They all wanted to make the change.”
Leading appraiser site visits
Maintaining a dedication to nursing excellence helps Magnet champions and ambassadors with one of their biggest roles – preparing units for Magnet site visits. At main campus, the ambassadors provide each unit a three-ring binder divided into the four Magnet components with space for clinical nurses to note where they are meeting exemplars and where they need to improve. “It’s like a playbook,” says Weber. “It helps promote continuous readiness.”
One of the greatest honors for an ambassador or champion is to be selected to accompany Magnet appraisers when they conduct site visits. At Hillcrest Hospital, the three champions who lead the site visits are called Magnet ambassadors. During the hospital’s most recent site visit in July 2019, the ambassadors “carried the visit,” says DeWalt. “The appraisers saw more than 460 people and were met by Magnet champions at every doorway. It went like clockwork.”
Becoming a Magnet champion is a coveted role at Hillcrest. Champions have the opportunity to serve on the hospital’s Magnet Steering Committee, which also includes nursing directors, nurse managers and other leaders. DeWalt says there is a waiting list to become a Magnet champion.
While serving as a champion or ambassador is a great addition to a resume, nurses at Cleveland Clinic understand the true value. “They make a difference,” says DeWalt. “The whole purpose behind Magnet is the patient – providing nursing excellence and caring for the patient.