March 18, 2005

VUMC going for ‘gold’ in nursing care certification

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Sabrina Downs, M.S.N.

VUMC going for ‘gold’ in nursing care certification

Vanderbilt University Medical Center could soon hold one of the highest honors an organization can receive for nursing care, as hospital administrators continue their work toward applying for and earning Magnet Recognition.

The American Nurses Credentialing Center created the Magnet Recognition Program to recognize health care organizations offering the highest level of nursing care, based on quality indicators and standards of nursing practice. Acting like a magnet, the program is designed to attract and retain the top nurses in their fields. These goals – and the pursuit of Magnet Recognition – are entertwined with elevate, the Medical Center's newly launched service improvement and operational excellence program.

Sabrina Downs, M.S.N., M.B.A., R.N., has been tapped to lead efforts to snag the top honor. She returns to VUMC after 12 years at Baptist Hospital where she was associate chief nursing officer for Cancer and Medicine. Previously, Downs worked at VUMC as a clinical manager and is a former master's student at the Vanderbilt University School of Nursing. “It's a great honor for me to lead this work because of my history here and my respect for Vanderbilt nursing,” said Downs.

In 2003, VUMC earned a federal grant of almost $1 million to begin working toward achieving Magnet status. 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 visit of all areas of operation.

“It's a large undertaking, because what it's doing is assimilating all the data of what nursing and the entire organization does well as far as patient care,” said Downs. “It's also about how we educate, advance, support and recognize our nurses at the clinical bedside and also in leadership,” she added.

Marilyn Dubree, M.S.N., R.N., chief nursing officer and director of Patient Care Services at VUMC, said the contribution of excellent nursing care for patients is invaluable to the Medical Center. “Our efforts for several years to 'Be the Best and Keep the Best' have supported the creation of an excellent practice environment for nurses and patient care. I am very proud of Vanderbilt Nursing and look forward to showcasing their efforts,” Dubree said.

Previous research shows hospitals with the Magnet honor tend to attract and retain the most elite and well-rounded nurses and other health care providers. Retaining experienced and highly skilled nursing staff has been shown to be directly linked with positive patient outcomes, which explains why previous research has shown hospitals with Magnet status report lower mortality rates, a shorter length of hospital stay, and fewer reports of patient falls.

Downs said some insurance companies and payers have begun to inquire whether a hospital has achieved Magnet status, and many new nursing graduates and potential employees inquire as to whether the Medical Center has been recognized. In the U.S. News and World Report magazine ranking of the best hospitals in the country, Downs said many topping the list have Magnet recognition.

“It puts things in place that gives nurses a chance to contribute and supports their professional development. If you have people who are supported in their jobs, all of that adds up to improved patient care,” said Downs.

Though the recognition comes from a nursing body and recognizes the work of nurses, Downs said earning and maintaining the honor will require a team effort at VUMC. “The nurse doesn't function solo. This is about collaboration with our physician colleagues and other members of the health care team. Nursing is not an island in providing patient care,” Downs said.

Norman B. Urmy, executive vice president for Clinical Affairs and chief executive officer, says the work under way to earn Magnet Recognition is closely connected to the goals outlined under elevate, the Medical Center's ongoing effort to improve service and operational performance at VUMC.

“The five focus areas that are the foundation of the elevate program include people, service, quality, growth and financial results. Each of these areas directly relate to the work that is needed – and much of what nurses in the Medical Center are already doing – to achieve Magnet status,” said Urmy.

Downs agrees that the two initiatives are closely linked. “The work toward Magnet Recognition does fall under elevate, in terms of how we educate and orient new people, nursing turnover, staffing ratios. Magnet looks at quality indicators. It goes hand in hand with our elevate work,” said Downs.

Elevate will be initiated by various leaders across the Medical Center in all disciplines, and will adopt a specific, detailed set of leadership principles and practices promoted by the Studer Group, the consulting firm engaged to assist in the elevate initiative.

Downs said she and Dubree are in the process of forming a Magnet steering committee, which will submit evidence to the Credentialing Center in October. A planned site visit will follow in the spring of 2006, and hopefully confirm VUMC's Magnet status later that year.

Magnet sites must re-submit evidence every four years to maintain the designation.

She said her new role doesn't mean she'll be looking to do things any differently. “It's just about getting recognition for what's been going on here and the work that's already being done,” Downs said. “There are great nurses here doing wonderful things, giving quality patient care. It's something that we want for our nursing staff here and for the pride of being a Vanderbilt nurse.”