Magnet designation pays off in more and better applicants
In a time of shortage, hospitals are looking for any and every way they can to differentiate themselves from other facilities. Being the employer of choice means fewer holes in the schedule, better patient outcomes, and a happier staff. For 67 hospitals around the country, one of the best ways they have found to differentiate themselves is by becoming Magnet-designated facilities. While it may not make the current nurse shortage disappear for those hospitals, it has given them an edge in attracting nurses and other health care workers to their ranks.
The Magnet Recognition Program was developed by the American Nurses Credentialing Center in 1994 to recognize health care organizations that provide the very best in nursing care. The program also provides a vehicle for the dissemination of successful practices and strategies among nursing systems. Based on quality indicators and standards of nursing practice as defined in the American Nurses Association’s Scope and Standards for Nurse Administrators, the Magnet program includes both qualitative and quantitative standards of measure.
The process isn’t easy, nor is it cheap (for a sense of what it costs to apply, see chart, below). But for hospitals that have gone through the process, there is a definite pay off. The first facility to be recognized was the University of Washington Medical Center (UWMC) in Seattle. "Back in those days, they were looking for organizations that were reputational magnets," explains Catherine Broom, ARNP, Magnet Project Coordinator at the hospital. "We were the only ones who met the criteria they developed."
Initially, there wasn’t a sense of what a hospital could get from the experience other than a well-deserved pat on the back from ones peers. "You can think what you want of yourself, but an external review acknowledges your strong points with a fair amount of credibility," says Broom.
Since that original designation, UWMC has gone through two recertifications — with a revised set of standards and a new panel of reviewers on the last go-round. "Four or five years ago, we didn’t have the same level of nursing shortage as we do now, so this last one came with a lot of introspection about how we are doing as an organization," she says. "We also had a complete change in our executive suite, and one of the things Magnet research has found is that executive changes can impact a hospital’s philosophy in a negative way — that changes often mean a lowering of the commitment to nursing practice. We have been fortunate that we have had continued support from the bedside all the way up to the boardroom."
During this shortage, Broom says she has seen the benefits of being a Magnet hospital. "I get contacted regularly from experienced and new nurses through the Magnet web site. They are looking for jobs or thinking of relocating to Seattle. They usually say something about how they hear we are the Magnet hospital in Washington and append a list of questions about it."
Judy Shorr, RN, MS, UWMC’s manager of nursing recruitment, sees the benefits of being a Magnet firsthand. "It’s not that it is a magic bullet," she notes. "But people see it in our advertising. Sometimes they seek us out because we are Magnet facilities. It tells them something about us right off the bat. But once they are here, you still have to live up to their expectations."
The University of California, Davis Medical Center (UCDMC) in Sacramento applied early on in the Magnet program, too, becoming the sixth hospital recognized as meeting the Magnet standards. Originally, the idea was simply to recognize the contributions the nursing staff made to the institution in terms of patient care and professional practice, says Carol Robinson, RN, MPA, CNAA, FAAN, senior associate director of hospital and clinics at UCDMC. "We are a relatively young school of medicine," says Robinson. "We are trying to build a reputation. Most of the time, though, we talk about the latest procedures and technological innovations. But we knew we had good outcomes, a great, safe patient care environment, and that our nurses were professionals. They were doing research, training, education, and were involved in national professional organizations. We really felt they should be recognized for that."
Back in the mid-1990s, the cost to apply wasn’t so high, Robinson says, and it was a fabulous way to help the nurses feel valued. "We didn’t have a high turnover rate, and we had low vacancy rates," she notes. "It wasn’t about what it could do for our recruiting and retention efforts. It was that we knew we met the standards and felt we deserved and our nurses deserved to be recognized for that."
The numbers tell the tale
Now it’s a great big plus that helps with recruitment, says Robinson. "In California, we are 49th of 50 states in number of nurses per 1,000 population. If we recruit from within our own region, we are taking nurses from other hospitals. Having this kind of national recognition helps us recruit from out of state."
Despite the dire situation in California, UCDMC still maintains turnover and vacancy rates that are below the national average. Turnover is 8.8%, which is higher than it was a year or so ago. "We are starting to see nurses retire, and we are having to hire younger, less- experienced nurses, which we didn’t have to do before, says Robinson. The vacancy rate is about 7%, down from a high last year of 10.5%. Part of that is because about 200 nursing positions that were added in the last two years were eliminated due to budget cuts. Still, the numbers are lower than the national average.
Oddly, Robinson says the most visible recruiting impact being a Magnet hospital has had at UCDMC seems to be with physicians. "For certain specialties, our Magnet status has been a factor in getting some physicians to come here." It also helps with retention of a variety of positions. "Creating a better working environment for the nurse means it’s a better work environment for everyone," she says.
Another benefit which is only just starting to become apparent is the ability to benchmark all sorts of data with other Magnet facilities. "The first four years we were a Magnet hospital the numbers just grew at a snail’s pace," says Broom. "At the end of six years, there were only like 16 facilities. Now we are starting to get the critical mass where the outcomes data related to nursing are apparent. We will soon be able to justify with numbers that the cost of the program is worth it."
But even in the absence of data, Broom thinks the money has been well spent at the UWMD. "There is a fair amount of cost involved, but it helps ensure that we are the best of the best in nursing practice."
Health care is a hard industry to work in now, says Robinson. "There is reduced reimbursement and the patients are sicker. Patients are scared of mistakes and want a lot of service for a little money. If you want to keep people working in that hard environment and provide the best possible care for patients, then you have to do everything possible to minimize the stresses nurses deal with. You have to listen to their concerns and issues."
Applying for Magnet recognition focuses on just those things, says Robinson. "I think it’s worth it for anyone to strive for those standards. If you don’t achieve it, it is still okay if you are making a difference in the every day environment. If you have a work environment where people have fun and enjoy what they do, people will want to be a nurse, stay a nurse, and stay there."
No, says Broom, it is won’t solve the nursing shortage problem by itself. "We still have to face reality, but for now, it still has a significance in recruiting and retention."
Editor’s note: For more information on the Magnet program, visit the American Nurses Credentialing Center web site at http://nursingworld.org/ancc/magnet/magnet.htm.
• Catherine Broom, ARNP, Magnet Project Coordinator, University of Washington Medical Center, Mailbox 356153, Seattle, WA 98195. Telephone: (206) 598-4627.
• Judy Shorr, RN, MS, Manager, Nursing Recruitment, University of Washington Medical Center, 1959 N.E. Pacific St., Box 356152, Seattle, WA 98195. Telephone: (206) 598-4466.
• Carol Robinson, RN, MPA, CNAA, FAAN, senior associate director of hospital and clinics, UC Davis Medical Center, 2315 Stockton Blvd., Sacramento, CA 95817. Telephone: (916) 734-2470.