


Magnet's history explains the program's growth and success
Leader discusses past and future of prestigious program


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The Magnet Recognition Program® has become a model for nursing excellence and quality patient care since the early 1990s. Over the years, a growing number of hospitals have pursued and achieved the prestigious Magnet® designation from the American Nurses Credentialing Center.

In the following Q&A, Rebecca Graystone, vice president of the
Magnet Recognition Program
and the Pathway to Excellence Program® at ANCC, talks about the history of Magnet, how the program got started and how it has evolved over the years. She also discusses the goals, objectives and benefits of Magnet, the elements of the Magnet model and potential changes that are being considered to the program.Could you discuss Magnet program history? How did it get started and how has it evolved over the years?
Magnet recognition started as a question related to retention. In the ‘80s, there was a terrible nursing shortage, but the American Academy of Nursing recognized there were pockets of hospitals across the country where you couldn’t get a job because there was a line out the door of nurses who wanted to work at those facilities.
A study of those hospitals showed common threads such as a structure supportive of nursing leadership, where staff nurses had autonomy and clinical authority in directing patient care. This led to the ability to attract and retain nurses, hence the term “magnet.”
The study further broke down this information into “14 Forces of Magnetism.” In 2008, these were consolidated into five components: Transformational Leadership, Structural Empowerment, Exemplary Professional Practice Exemplary Professional Practice, and New Knowledge, Innovations, and Improvements, Empirical Outcomes. Those five elements are still pertinent and very relevant today.
What are the major goals of the program?
The primary goal is to improve healthcare around the world through nursing excellence. We recognize the value RNs bring to the care of patients and families. A big part of our program is looking at the structure of those nurses’ practices and the leadership that guides them when they make decisions about work environment, practice and patient care.
Nurses have historically not taken the front seat when it comes to driving quality, but in the last two decades, nurses are really starting to find their footing. Quality healthcare is the least expensive, so the higher the quality of care, the lower the costs.
What are the major benefits to facilities of achieving recognition?
If nurses are practicing in an environment where they feel supported and can make decisions about their practices, nurses will thrive, and that’s when patients thrive which is the No. 1 goal. Attraction and retention of RNs definitely are benefits. If you have satisfied nurses, you should rely less on premium labor [such as] agency nurses or per diem nurses, which are very expensive resources. Magnet recognition is a testament to the world, not just to patients, but also to healthcare providers who might be interested in working at that organization.
What are some of the most common questions or concerns facilities have when they consider applying for Magnet status?
If I were a chief nursing officer, I would ask, “What benefits does this bring to patients, how does it help my RNs maximum their professional personal goals and where are the data that demonstrates this makes a difference?”
Some organizations want to know how long it will take to achieve Magnet designation. First, the application is submitted online, typically 12 to 24 months in advance of supporting documents. Once the documents are received, the timeline for review and evaluation begins. It’s typically eight to 12 months to find out the decision from the Commission on Magnet Recognition.
But there has never been one organization I’ve ever spoken with who has ever said, “I wish we hadn’t done this.” Even if they don’t achieve recognition on their first try, they will say, “This has transformed our organization and our nursing team.”
Could you briefly discuss the five elements that make up the Magnet model?
- Transformational Leadership – Transformational leaders are those who both stimulate and inspire followers to achieve extraordinary outcomes. Any success an organization has often goes back to leaders and how they’re guiding and challenging others to think critically and grow and develop.
- Structural Empowerment – It means nurses are involved in decision-making about their own professional practice, about healthcare outcomes, about organization strategy and goals. Nurses are positioned to influence the organization.
- Exemplary Professional Practice – Nurses have a concept or theory that organizes how they deliver their practice, which is dependent on the community they serve. It’s a model around how they work, including inter-professional collaboration, and partnering with patients and families to deliver high-quality care.
- New Knowledge, Innovations, and Improvements – This revolves around the science of nursing. What is an organization doing to promote nursing research? Is their nursing practice based in evidence? Is there a culture of inquiry and how does the organization support that? It’s looking beyond what’s always been done to a new way of providing care.
- Empirical Outcomes – This is not a section by itself; it’s interwoven into each component. In each component, organizations must be able to empirically demonstrate the improvements they’ve made.
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EDITOR'S NOTE:
Rebecca Graystone, MS, MBA, RN, NE-BC, is vice president of the Magnet Recognition Program® and the Pathway to Excellence Program®. Graystone has 24 years of acute care nursing practice and leadership experience, primarily in the Washington, D.C. area. She has presented extensively on Magnet topics and teaches numerous program guidance courses sponsored by the program.
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