During her interview process at Chicago's Memorial Children's Hospital in 2000, chief nurse executive (CNE) applicant Dr Michelle Stevenson, RN, inspired the executive team and professional nursing workforce to pursue American Nurses Credentialing Center Magnet Recognition(R). Under her leadership, the hospital achieved Magnet(R) designation the following year.
Dr Stevenson was a pioneer among pediatric hospital CNEs. Memorial Children's Hospital (Ann & Robert H. Lurie Children's Hospital) was the 1st pediatric hospital in the country, and the 1st hospital of any kind in Illinois, to achieve Magnet designation. As an early adopter, Dr Stevenson recognized the power and benefit of Magnet status for her patients, for the nurses, and for the organization. Not only did she inspire followers in her own hospital and state, but also, she inspired CNEs at children's hospitals across the country. She was a true transformational leader as described in the Magnet sources of evidence.1
There is strong evidence in nursing professional literature of the value of Magnet designation to patients, nurses, and hospitals yet little evidence specific to the pediatric hospital. Despite this lack of measurable data, increasing numbers of CNEs at pediatric hospitals have followed Dr Stevenson's example and embarked on the Magnet journey. They recognize the value that Magnet can bring to the patients and communities they serve in addition to elevating the status and performance of the nurses.
As more children's hospitals have earned Magnet designation, the body of research confirming these benefits has grown. In 2009, Lacey et al2 published findings that pediatric nurses who work at Magnet hospitals reported better perceptions of organizational support, workload, intent to stay, and overall satisfaction than did those working in non-Magnet pediatric hospitals. In 2013, Blake et al3 studied healthy work environments in 10 pediatric intensive care units (PICUs). Eight of them were in Magnet-designated hospitals; the other 2 were in hospitals on the Magnet journey. Nursing leadership was found to be the most important factor related to low "intent to leave" and low turnover among PICU nurses. This is consistent with the evidence driving the Magnet components.1
Positive research findings, in turn, have motivated more children's hospitals to take the Magnet journey. Of freestanding pediatric hospitals in the United States, more than half are now Magnet designated. Many of the rest have strategies in place to pursue designation. My recent appointment as the 1st member of the Commission on Magnet from a pediatric hospital is evidence of the program's awareness of the growth of this group.
Magnet's quality standards perfectly align with those of children's hospitals nationwide. In more than 20 years of collaborating with CNEs at these organizations, I have found an intense commitment to perfection. I have never heard anyone say, "This is good enough." When it comes to patient safety and quality outcomes, pediatric hospitals strive to find and share new knowledge and innovative ideas for clinical improvement on a regular basis.
As these hospitals seek Magnet designation and redesignation, they take a leadership role in developing mechanisms to establish national benchmarks for pediatric indicators. One recent example is research to better understand and prevent pediatric inpatient falls. From this group effort, there is growing evidence that pediatric inpatient fall rates and contributing factors are very different from adult/geriatric rates and injuries are not as severe.4
Such impressive interprofessional collaboration has inspired ever-higher levels of commitment to improve pediatric patient safety. For example, Ohio's 8 children's hospitals banded together to implement initiatives that reduced risk to pediatric patients across the state, including a 60% drop in surgical site infections and a 34% decline in adverse drug events.5
Their innovative work inspired "Solutions for Patient Safety,"6 a national collaborative among 34 children's hospitals across the country developing and establishing best practices around issues of patient safety. The collaborative's mission is rapid learning and sharing of knowledge to lower risk to zero among pediatric hospitals nationwide.
Perhaps, nowhere is Magnet's influence stronger than in the evolution of patient and family engagement. Fifty years ago, children's hospitals focused solely on curing disease. Parents had a passive role. But gradually, nurses and others recognized that it was developmentally important for family members to become involved. Today, family-centered care has become more prevalent in pediatric hospitals. Parents-and young patients themselves-are actively engaged in treatment, care plans, and discharge goals.
Magnet standards are driving this change. They are motivating us to seek tools and processes to better support healthy, well-informed parents and patients as we move toward full family partnership in the care of hospitalized children.
References