The attraction of Magnet
Can Magnet, Joint Commission prep teams be of use to each other?
It is not surprising that in the competitive healthcare marketplace, for some facilities, getting the stamp of approval from The Joint Commission just isn't enough. So they seek other avenues to prove that the quality of care they deliver is stellar. For some, the nurse-centric Magnet journey is the obvious next choice. Nurses, after all, hold a special place in the hearts of just about everyone. Being able to say your hospital not only does well by its patients but does well by its nurses, who are responsible for the hospital being a great place to work and get well — it just makes sense.
It also seems to make sense that the folks who work on getting ready to pass a Joint Commission survey would be ideally placed to help a hospital prepare for the parts of the Magnet process related to quality. (For more on the entire Magnet process, see page 3.) But that is something that apparently rarely happens, says Michelle Janney, PhD, RN, NEA-BC, senior vice president and Wood-Prince Family Chief Nurse Executive at Northwestern Memorial Hospital, which has been a Magnet facility since 2006 and was reaccredited in 2010.
"The broad answer is that we all work together to advance quality, and that is the agenda of everyone every day," says Janney. "When you get down into the weeds, though, it is a harder answer."
Magnet and The Joint Commission measure quality differently, she says, so preparation is different. "There is overlap and integration, but the goals are not the same. The mechanism for The Joint Commission is compliance with a standard. Often a minimum standard that everyone has to meet."
Magnet, however, is about excellence, surpassing the norm, and being better than almost everyone else. Not every hospital will be a Magnet facility because part of the deal is being exceptional, and being committed to excellence and innovation. "Both are critically important things," Janney says of preparing for accreditation by the two organizations. "I'm not sure that you want to blend them, though."
But the two entities themselves work together to some degree, and certainly they acknowledge each other's importance in the quality improvement field, says Linda Lewis, MSA, RN, NEA-BC, FACHE, the director of the Magnet Recognition Program for the American Nurses Credentialing Center (ANCC) in Silver Spring, MD.
The two organizations have discussions regularly, with someone from Magnet involved in The Joint Commission's nursing advisory council. The Joint Commission has also held conference sessions on the benefits of seeking validation from Magnet or the Baldrige Performance Excellence Program. Last March the commission even created an entire report comparing and contrasting Joint Commission, Magnet, and Baldrige principles and approaches. (The full report can be seen at http://www.jointcommission.org/assets/1/6/Comparison_Document2013.pdf.)
Leaving aside Baldrige, some of the standards for Magnet and The Joint Commission are similar enough that there is a crosswalk manual to show the parallels. For instance, one page in a crosswalk standard document includes this coupling of Joint Commission Standard number LD.02.01.01: "The mission, vision, and goals of the hospital support the safety and quality of care, treatment, and services." — with Magnet Recognition Program EP1: "The governing body, senior managers, and leaders of the organized medical staff work together to create the hospital's mission, vision, and goals (See also NR.01.01.01, EP 2)." And EP2: "The hospital's mission, vision, and goals guide the actions of leaders."
"So there is synergy on the table," says Lewis.
But why isn't there any concerted effort to take what one group knows about Magnet accreditation and leverage it when The Joint Commission comes knocking? Why can't the stuff that the quality department works so hard on to be always ready for a survey be of use for Magnet recognition?
Lewis does not see any reason why the two groups can't work together. "In places where I have been chief nursing officer and the processes happen one after the other, having one be a success can give the other team a boost as they prepare. And while a Magnet application document may go many times more in depth than what you need for a typical Joint Commission survey, I think that the groups can certainly be of use to each other."
Both processes require the best of frontline staff, and many of the standards are the same, so getting both groups of people — those who focus on Magnet preparation and those who work on Joint Commission surveys — to sit around the table to talk about meeting standards and getting ready can only help. She mentioned that the people who work on Magnet applications "often know where the best stories in the house are, so be sure to ask them to share."
But be careful. Lewis says it would be a mistake to give anyone working on Magnet the idea that the program was getting a whiff of the regulatory about it. That it is voluntary and exclusive is part of what makes earning the achievement so special to those hospitals that make it — something only about 6% of U.S. healthcare organizations have achieved once, and half that number manage to repeat, according to Janney.
If nothing else, Lewis says, you'll get more people having conversations about quality, and that can't be a bad thing. And in a best-case scenario, you can have some cross-pollination on strategies to meet requirements, achieve new goals, or troubleshoot problems.
For more information on this topic, contact:
- Michelle Janney, PhD, RN, NEA-BC, Senior Vice President, Wood-Prince Family Chief Nurse Executive, Northwestern Memorial Hospital. Chicago, IL. Telephone: (312) 926-2000.
- Linda Lewis, MSA, RN, NEA-BC, FACHE, Director, Magnet Recognition Program, American Nurses Credentialing Center, Silver Spring, MD. Telephone: (800) 284-2378.