When Terri Murray, MSN, RN, NE-BC, was nurse manager of the cardiovascular stepdown unit at Cleveland Clinic’s main campus in 2017, she led the charge to apply for a Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN). “I heard rumors that stepdown units don’t really apply, but we decided to go for it,” recalls Murray, now nursing director of the Respiratory Institute, Head and Neck Institute and Infectious Diseases. “That opened the door.”
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The cardiovascular stepdown unit earned the award and was redesignated at the silver level in 2020. Since the initial award, two other stepdown units at main campus have won a Beacon award. At the end of February 2021, a total of 11 units at Cleveland Clinic – from main campus, Euclid Hospital, Fairview Hospital and Medina Hospital – had gold or silver level designations.
“It validates the caliber of nursing that is provided on those units,” says Rosslyn VanDenBossche, MBA, BSN, RN, NE-BC, nursing director of the Heart, Vascular & Thoracic Institute. “Units that achieve the award stand out in comparison to others, and they should be really proud of that. Their frontline caregivers make a difference.”
Focus on the journey, not the destination
The AACN says its Beacon Award for Excellence “recognizes caregivers in stellar units whose consistent and systematic approach to evidence-based care optimizes patient outcomes.” Units are awarded one of three levels of designation that acknowledge significant milestones on the journey toward excellence: gold, silver and bronze. To be eligible, units must submit a unit profile and meet defined criteria in five categories:
- Leadership Structures and Systems
- Appropriate Staffing and Staff Engagement
- Effective Communication, Knowledge Management and Learning Development
- Evidence-Based Practice and Processes
- Outcome Measurements
“It truly is a journey,” says Sue Wilson, BSN, RN, CCRN, NE-BC, nurse manager of the surgical intensive care unit at main campus. “At the outset, you might not think you are good enough to win a national award. As you complete the application, you realize that the unit is doing great things and providing great care.” Wilson is wrapping up the surgical ICU’s third Beacon application. The last time around, the 30-bed unit earned a gold award.
Six tips for units pursuing the Beacon award
When the cardiovascular stepdown unit at main campus first embarked on the Beacon journey, Murray sought out nurse managers from other ICUs that had won the award. “I found mentors who shared their documents and offered advice on putting the application together,” she says. “I didn’t have to operate in a vacuum because we had experts right down the hall.”
Not all nursing units are so fortunate to have Beacon winners in their facilities, so Murray, VanDenBossche and Wilson have compiled six suggestions:
- Don’t adopt an “all or nothing” attitude. “Some units may be disappointed with a bronze or silver award, but any one of those distinctions is amazing,” says Murray. “And it gives you a level to aspire to next time around.”
- Create a Beacon team. “One person can’t tackle the application alone,” says Murray. “Find a group of people on the unit who are committed to the process, start with the end goal in mind and stay focused.” Consider holding regular meetings to keep the team on task.
- Divide and conquer. “Once you’ve identified your team, then divide the application into its five components and assign them to individuals,” says Murray. “Everyone works independently on their section, then they come together and review one section at a time.”
- Ask for input from clinical nurses. Even if you have a core committee in place, Wilson recommends asking the day-to-day caregivers and assistant nurse managers on the unit for input too. They will likely have great ideas on answering some of the detailed questions in the application, which cover a wide array of topics from how the unit maintains a safe environment to what pain management tools are used and how caregivers incorporate patients and families in patient care decisions.
- Use the feedback from the AACN to make improvements. Beacon applicants and awardees receive a comprehensive feedback report that includes strengths and opportunities for improvement to chart their excellence over time. When the surgical ICU began the Beacon process more than a decade ago, the unit’s pressure injury prevalence was in the double digits. Last year, the SICU had a 1.97% pressure injury prevalence rate. “We have made a lot of improvements over the years,” says Wilson. “We have upgraded our hospital beds, conducted a lot of pressure injury education for our nurses and clinical technicians, and increased the number of skin care resource nurses on our unit.”
- Don’t get too hung up on metrics. While outcomes are important, Beacon applications tell a unit’s story of resilience, says VanDenBossche. “Everyone would love to have wonderful metrics all the time, but we know that numbers sometimes go up and down,” she says. “They want to hear examples of times when things didn’t go right and the unit intervened to correct the situation.” For instance, the medical ICUs at main campus just completed their Beacon application after a year of treating COVID-19 patients. There were admittedly some bumps in the metrics. “We told the story of how our team came together to help this very vulnerable patient population, and what we are doing to move forward,” says Murray.
Ultimately, the Beacon application unfolds a story of a nursing unit’s continuous pursuit of excellence. How can you tell your story from start to finish?
“Nurses don’t give themselves enough credit for the work they do every day because it becomes so routine and familiar to them,” says VanDenBossche. “To have a highly regarded, external organization validate our work is so rewarding.”