Marymount Hospital: A Model of Nursing Excellence

Throughout the COVID-19 pandemic, Cleveland Clinic Marymount Hospital not only fought to curb the coronavirus, but it remained committed to maintaining outstanding nursing clinical indicators. In May, the 269-bed acute care community hospital was recognized for going above-and-beyond, earning its first Magnet® designation, as well as nine exemplars from the American Nurses Credentialing Center (ANCC) for exceptional practices in the following areas:

• Satisfaction and Engagement Rates
• Nursing Quality Outperformance – Inpatient Setting
• Nursing Quality Outperformance – Ambulatory Setting
• Patient Satisfaction – Ambulatory
• Innovation
• Technology Involvement

“The exemplars validate the excellent work that nurses provide to our patients,” says Barbara Zinner, DNP, RN, NE-BC, CENP, vice president of nursing and chief nursing officer of Marymount Hospital. “Recognition from the ANCC sends a message to our nurses that they make a difference and they are valued.”

Earning distinctions on quality indicators

Magnet appraisers were particularly impressed with the hospital’s quality, leadership and outcomes, says Denise Griffin, MBA, MSN, RN, NE-BC, Magnet program manager for Cleveland Clinic.

“Marymount Hospital has outstanding nursing quality programs and processes,” she says. “The majority of the exemplars were based on quality – zero CLABSIs, zero CAUTIs the majority of time during the reporting period across the entire organization. The nurse clinical indicators are spot on.” The hospital also outperformed the national mean for hospital-acquired pressure injuries Stages 2 and above, as well as falls with injury and patient burns in the ambulatory setting.

The achievements are especially rewarding considering that data from 2020 is included. “Even during the last year with COVID-19, our quality indicators did not vary,” says Zinner. “Our staff remained committed to quality, and it showed in the metrics we presented in our Magnet documentation.”

Excellence continues even during a pandemic

COVID-19 set the stage for another exemplar achieved by Marymount. During the pandemic, the hospital was designated a hub COVID-19 hospital for the Cleveland Clinic enterprise, an unplanned change that required nurses to identify and participate in innovations throughout the organization to successfully provide patient care and support staff. Magnet appraisers recognized the contribution of nurses in three primary areas:

• Innovations in facilities – The Emergency Department converted its waiting area to a negative pressure space called “the box” to care for COVID-positive patients and individuals under investigation. It kept COVID-19 patients away from others requiring emergency services and supported effective clinical care.
• Innovations in staffing – Nurses and other staff were reassigned to intensive care and medical units to care for COVID-19 patients from areas where patient volume decreased, including the ambulatory surgery center and older adult behavioral health units. They were trained for new assignments and provided mentors.
• Innovations in caregiver support – Several initiatives were launched by the Cleveland Clinic Health System and Marymount Hospital to support the health and wellbeing of staff, including a COVID-19 caregiver hotline, meal delivery, an employee care fund, housing accommodations for caregivers who wanted to shelter away from families and more.

Throughout the pandemic, nursing leaders did more than provide emotional support to frontline caregivers. They frequently donned personal protective equipment and worked side-by-side with clinical nurses on all shifts.

“Nursing leaders did what they had to do to live our mission of putting patients first and taking care of our caregivers,” says Zinner.

A voice at the table is key to success

Achieving Magnet designation and earning nine exemplars highlights the importance of nurses being consulted and heard within the hospital. “Having a voice is what it’s all about. During the appraisal process, our nurses used their voices and shared stories,” says Zinner. “The one great takeaway from the Magnet journey is to let your nurses brag about the work they are involved in and keep your nurses at the table.”

When any committee is formed or planning meeting is scheduled, Marymount Hospital leaders ensure nursing is represented. “Their opinions and concerns are very important,” says Griffin. “I’m so proud of this hospital! Nurses went above and beyond what was expected and received deserving recognition from the ANCC.”

It was the culmination of years of hard work in collaboration with physicians, physical therapists, respiratory therapists, dieticians and many others at the hospital. “While this is a recognition of nursing excellence, nursing can’t be excellent without support from every other caregiver,” says Zinner. “The nine exemplars really represent every caregiver giving 100% to live our mission.”