October 24, 2003

VUMC gains grant to begin gold standard accreditation process

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Nancy Wells

VUMC gains grant to begin gold standard accreditation process

VUMC will receive a federal grant of almost $1 million to address nurse recruitment and retention and its impact on the quality of care delivered at VUMC. Nursing officials said the goal for the Medical Center is to achieve Magnet status — the highest award an organization can receive for nursing care — by 2005.

Magnet was developed by the American Nurses Credentialing Center, a division of the American Nurses Association in 1994.

Magnet Hospitals are held as the gold standard by which nursing and patient care is measured in the United States. The Magnet application covers nearly 100 criteria points, with an on-site inspection of all areas of operation.

Nancy Wells, D.N.Sc., research associate professor of Nursing and director of VUMC Nursing Research and the principal investigator on the grant, said the funding will allow VUMC to begin the work that is needed to make sure the application process is successful.

“This grant will pay for every unit’s board leader in the Medical Center to go through facilitation training. This training supports our model called ‘shared governance,’ which provides the structure for and outlines the process of shared decision making at the point of service,” said Wells. “It helps nurses to have control over nursing practice decisions and opens the door for better communication and collaboration,” she added.

“This type of model is critical for an institution to demonstrate performance of the standards of care outlined by the Magnet Recognition Program,” said Marilyn Dubree, MSN, chief nursing officer and director of Patient Care Services, and a co-investigator on the grant. Dubree said hospitals that have obtained Magnet status have maintained some form of shared governance.

Shared governance is the foundation for strong nursing practice and is critical to our demonstration of Magnet qualities,” Dubree said.

Becky Keck, MSN, assistant hospital director for Nursing Finance and Operations is also a co-investigator on the grant.

“I am very excited to have been able to work in a collaborative manner with Dr. Wells and Vanderbilt’s School of Nursing in the original submission of the grant ‘Interdisciplinary Communication: Path to Magnet Hospital,’” said Keck.

The Learning Center will help train VUMC nurses on the shared governance model. “It’s a way to hear all voices and to make decisions closest to the patient in unit and clinic boards,” said Cheryl London, a consultant with the Learning Center. “We’ll help to train unit and clinic board chairs and assist with communication about progress throughout the year,” she added.

Hospitals recognized with a Magnet award tend to attract and retain the most elite and well-rounded nurses and other health care providers, and typically have better staffing ratios and leadership structures than other health care providers.

Retaining experienced and highly skilled nursing staff has been shown to be directly linked with positive patent outcomes, which explains why previous research has shown hospitals with Magnet status report lower mortality rates, a shorter length of stay, and fewer falls.

Though VUMC has already begun to address nurse retention issues with its “Be the Best—Keep the Best” initiative, Keck says Magnet would take the Medical Center one step further.

“The goals of a magnet recognition program are to identify excellence in the delivery of nursing services to patients and clients, promote quality in a milieu that supports professional practice, and provide a mechanism for the dissemination of “best practices” in nursing services.“

“This self assessment process that we will undertake in our application for Magnet Nursing Services Recognition Program will allow us the opportunity to celebrate the work we are doing well and continue our efforts in creating a professional nursing practice environment. This should have a very positive impact for our internal staff at Vanderbilt as well as assist us in our external recruitment efforts,” Keck said.

The grant will cover five years of work involved with applying for and earning Magnet status.

Wells says the major work will be completed within the first three years, and the last two will be spent monitoring and evaluating the impact of the grant.

The current plan is to implement shared governance by June 2004; the application for Magnet status will be submitted in December 2005 and a site visit will be conducted in the spring 2006.