Subject matter experts with a broad collection of perspectives-the Commission on Magnet(R), professional association members, chief nursing officers, Magnet program directors, and Magnet program staff-among others, contributed invaluable perspectives and insights to inform this latest edition. These collective insights, coupled with a rigorous review process, resulted in a nursing credential substantiating the value that empowered professional nurses contribute to patients, families, the organization, and their community. The changes in the 2019 Magnet Application Manual1 clarify previous standards, reduce the volume of requested information, and expand documentation requirements for the outpatient arena and for nursing research.

Many elements within the manual have not changed. Some examples include the Magnet Model, the eligibility requirement for baccalaureate in nursing or higher prepared leadership, and the continued focus on empirical outcomes including those compared against national benchmarks (innovation, research, and interprofessional collaboration). The current 4 phases of the Magnet appraisal process are unchanged. These include application, submission of written documentation, site visit, and Commission on Magnet Recognition decision. The written documentation and site visit phases require a thorough and comprehensive review by at least 3 independent expert appraisers who determine whether the organization meets a threshold of excellence. The Commission on Magnet Recognition receives the appraisers' comprehensive reports for final deliberation and decision.

As the 2019 manual1 continues to raise the bar for excellence, major highlights of changes include the following:

* Fewer organizational overview (OO) items: The number of OO items dropped from 20 to 10. Each OO item represents a foundational element of a Magnet culture and must be present and operational in the applicant organization. Overlapping requirements within the standards led to the removal from the OO or movement of that element to the standards section.

* Clarification of leadership titles and roles: The term nurse leader is replaced with assistant vice president/director. Nurse managers remain unchanged, and documentation provided at the time of application to demonstrate academic preparation of leadership is streamlined. The focus remains on the Magnet-defined function, not on the specific title of the RN serving in a leadership capacity.

* Expansion of requirements for outpatient settings: Nine standards require applicant organizations to describe and demonstrate achievement of requirements in outpatient settings. Six of the 9 require demonstration of empirical outcome data. The expansion into outpatient reflects contemporary trends in healthcare delivery and the critical impact RNs have in these expanded settings.

* Transition-to-practice requirement: For the 1st time, the 2019 manual standards provide applicant organizations the ability to meet a standard by providing evidence of a current, nationally accredited transition-to-practice program certificate. A copy of the current certificate provided as evidence fully satisfies the standard. Alternatively, if the applicant organization's transition-to-practice program is not accredited, 3 examples must be described and evidence must be provided to demonstrate integration and effectiveness of the 6 transition-to-practice elements in each example.

* Nursing research: Nursing research requirements now include a total of at least 3 nursing research studies presented in the applicant's documentation. Two of the 3 studies must be complete. The 3rd nursing research study must be open or ongoing. This increase in nursing research studies supports the imperative that nurses in Magnet-recognized organizations are involved not only in evidence-based practices but also in creating new knowledge. Applicant organizations provide the infrastructure and resources to advance a multitude of nursing research activities within practice environments.

Magnet designation is attainable by healthcare organizations regardless of size, setting, or location. Revisions to the manual provide clarity and relevance to consistently demonstrate the value of nursing care across healthcare settings, populations, and geography. Collectively, the enhancements afford organizations an evidence-based, data-driven framework to achieve excellence in processes, structures, and, ultimately, patient-centered outcomes. Like our colleagues in practice and leadership, Magnet is evolving. The 2019 Magnet Application Manual1 was released in October 2017 and is effective as of February 2019. For more information about the "Journey to Excellence," visit http://www.nursecredentialing.org/Magnet or contact the Magnet Program Office at mailto:[email protected].

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