tag:blogger.com,1999:blog-32053362.post302007495249695324..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: De-MagnetizingPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-32053362.post-87205302417712163492016-04-05T09:45:57.517-04:002016-04-05T09:45:57.517-04:00I work at a magnet institution. Paid education an...I work at a magnet institution. Paid education and a nursing clinical ladder are two positives for nurses and provide an actual opportunity for professional advancement. Everything else is phoney, big sounding words with nothing behind them. Shared decision making, nurse to patient ratio based on acuity, all of it is a lot of hot air. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-76021549463963877292015-01-27T18:49:58.361-05:002015-01-27T18:49:58.361-05:00I am very dis engaged with Magnet status and what ...I am very dis engaged with Magnet status and what it is supposed to stand for. My organization changes the rules about what is required for Magnet to meet their decisions. We were told Nursing directors are required by Magnet to hold an MSN to be eligible for that position, but there are many nursing Directors that do not have that degree. Nurse managers are told they cannot fill that role unless they hold a BSN, but again 2 managers did not have that degree for 5 years after being promoted. We were told all managers and directors must have a nursing certification or lose their position, two managers were demoted but 4 managers still do not have a nursing certification. I cannot see any benefit to working for a magnet facility the nursing ratio's are well above the national standard, we are running very understaffed more with less, I guess Magnet does not care about this but they do look at patient satisfaction scores that are not even close to what is needed for recertification. I am sure the hospital will juggle the scores around and pad them to meet the standard> From my stand point I am looking for a new place to work, one that respects the care staff provides with compassion and passion for patient needs. I want an organization that has values and beliefs that they stand behind and are not just words on a wall> I am doing the job I was meant to do and that is nursing I just want to do it with a little support and without a fake Magnet statusAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-10911948178984986592012-01-18T17:42:17.761-05:002012-01-18T17:42:17.761-05:00In response to anonymous 0930 and Paul's comme...In response to anonymous 0930 and Paul's comment of 0938: I reviewed the reference list provided at the indicated website. Let us clarify the question here: it is, is there peer-reviewed evidence that Magnet hospitals provide higher quality patient care than non-Magnet hospitals?<br />Reviewing the reference list, there appear to be few articles that address this specific question. Most appear to be related to nurse practice environment or nursing perception of work environment, rather than directly measuring quality of PATIENT care. One cannot use nurse practice environment as a surrogate marker here.<br /><br />The only article I see that might, even tangentially, address this question is:<br /><br />Armstrong K, Laschinger H, Wong C. Workplace empowerment and Magnet hospital characteristics as predictors of patient safety climate. J Nurs Care Qual. 2009 Jan-Mar;24(1):55-62<br /><br />It would be interesting if anon 0930 could provide the abstract of this article.<br /><br />nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-50046289011986538972012-01-18T11:19:29.080-05:002012-01-18T11:19:29.080-05:00In addition to the financial costs of completing t...In addition to the financial costs of completing the application and review process for this and other such awards, there is a tremendous opportunity cost. I have assisted some of the nursing comittees who spend considerably time completing the application and reveiw process. I wonder what the results might have been had this time been devoted to direct quality improvement. Additionally, if an institutions chooses to prioritize these applications and yet does not appear to provide the same resources and time to direct quality improvement, it sends a clear message to its employees about the true priorities of the organization. <br /><br />Regarding the issues of the predominant association between such designations and outcome - this would be an easier inference to make if there was a transparent reporting of the data. Ultimately, the costs of these applications must be paid for by health care dollars - therefore, they should have some semblance of cost-effectiveness - with an asessement that includes the man-hour costs of the application and review process.James M. O'Brien, Jr., M.D., M.S.https://www.blogger.com/profile/01257286674480575518noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-37756637559646910782012-01-18T09:38:16.912-05:002012-01-18T09:38:16.912-05:00In all fairness, it would also be good to know the...In all fairness, it would also be good to know the author of this comment, but as always, that is your choice.<br /><br />I'm sorry to say that the web page you cite is, to me, incomprehensible. What does this mean, for example:<br /><br />"This reference list includes research studies that have investigated the relationship between Magnet Environments and Patient, Nurse, and/or Organizational outcomes. In general, findings have consistently demonstrated an association between Magnet Characteristics and favorable Nurse or Patient outcomes. The most common approaches to measuring Magnet Characteristics have been to include ANCC Magnet-recognized Organizations in the study sample or to administer a version of the Nursing Work Index survey, which was initially developed to characterize a Magnet Environment."<br /><br />And why does it say this:<br /><br />"ANCC cannot provide copies of any articles listed here."Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-45536063140209711162012-01-18T09:30:21.143-05:002012-01-18T09:30:21.143-05:00In the interest of fairness I suggest actually loo...In the interest of fairness I suggest actually looking at the data and how it was obtained before declaring it a valid study to base opinions on. <br /><br />Summary: The research study is problematic on many fronts, not the least of which is that the data set was from 2005 (6 years old); the data set is specific to UHC hospitals (academic medical centers); and there were only 19 Magnet hospitals in the study. <br /><br />1. The study used data from 2005, 6 years old, and a full three years before the Magnet model was updated in 2008 to include outcomes. The sample size was limited to only 19 Magnet hospitals. This time lag and the scope of the change in the Magnet requirements call into question the relevance of the study for today‟s researchers. While the study shows statistically significant differences (p<0.05) the clinical significance was not addressed.<br /><br />2. The study methodology selected University Health System Consortium (UHC) hospitals for its data samples. UHC hospitals, the majority being academic medical centers, can be expected to have "better than average‟ patient outcomes and higher staffing hours primarily due to higher patient acuity and complexity (CMI). Additionally, UHC hospitals have likely implemented many of the evidence-based practices that are the hallmarks of Magnet. The study does not identify the extent to which Magnet and non-Magnet hospitals within the UHC are different on the features that statistically differentiate Magnet hospitals from non-Magnet hospitals in the general hospital population.<br /><br />Over the past six years, there has been a growing body of research showing that Magnet characteristics do impact patient outcomes. This evidence is highlighted on the ANCC website at http://www.nursecredentialing.org/MagnetReferences.aspxAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-52477667775171547012012-01-18T09:14:42.024-05:002012-01-18T09:14:42.024-05:00You raise this question:
"With all that it ...You raise this question: <br /><br />"With all that it takes to receive Magnet® status, and with all the assertions by the ANCC about the superior nature of Magnetized institutions, what peer-reviewed data exist that support the assertion that such hospitals do in fact deliver higher quality patient care than the non-Magnetic hospitals?"<br /> <br />Perhaps an even better one would be: "How can an organization that purports to be quality-based, not have "evidence-based" (i.e. Objective) data to support its reason for existing?<br /> <br />And the followup question: Isn't this, in fact, the most basic element of what such a program preaches?Peter Loguehttp://www.twinpeaksgroup.com/noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-40715220016333784542012-01-18T08:40:18.744-05:002012-01-18T08:40:18.744-05:00This post demonstrates, yet again, the general pri...This post demonstrates, yet again, the general principle that seemingly intuitively obvious conclusions about health care - be they clinical conclusions or quality- or policy-related - are entirely unreliable. If an organization is going to make a statement such as the one below:<br /><br />"The Magnet Recognition Program® recognizes healthcare organizations for quality patient care..."<br /><br />the statement must be backed up by real data, or it cannot be construed as anything but advertising. The FDA has penalized drug companies for making such unsupported claims. <br />I am told this program has existed for over a decade. Should the hospitals now ask for their money back?<br /><br />nonlocalAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-7233652009222557222012-01-18T05:13:48.361-05:002012-01-18T05:13:48.361-05:00What you wrote is important. When I need medical c...What you wrote is important. When I need medical care I want to see a hospital's run charts on readmissions or falls on their website rather than a big shiny Magnet sign on the front of the building. I know which action speaks more to the beliefs and values of the team I'm entrusting with my health.Anonymousnoreply@blogger.com