Financial Benefits Financially, healthcare organizations are finding significant advantages. The cost of replacing a single professional nurse ranges from $48,000 to $64,000 (Advisory Board, 1999). The improved attraction and retention of professional nurses results in significant cost savings. In addition, temporary labor costs are decreased, beds remain open, and hospitals experience a decrease in the frequency of diverting patients they cannot accommodate. Additionally, healthcare organizations that achieve Magnet status are able to negotiate stronger payor contracts, increase market share, decrease insurance and legal fees related to medical malpractice, and refinance stronger bond rates (American Nurses Credentialing Center, January 31, 2005). Benefits of Becoming a Magnet-Designated Facility Magnet designation is an important recognition of nurses' worth Magnet designation is a major factor in nursing recruitment and retention Magnet designation means a competitive advantage Magnet designation attracts high-quality physicians and specialists Magnet designation reinforces positive collaborative relationships The magnet designation process creates a "Magnet culture" Magnet designation improves patient quality outcomes When marketed effectively, Magnet designation increases use of the health care organization by consumers and health care plans. Eligibility criteria Entity. The applicant organization must exist within a healthcare organization. Organizations interested in applying as a system should refer to Appendix E in the Magnet application manual; click here to view. Nursing leadership. The applicant organization must include one or more nursing settings with a single governing authority and one individual serving as the Chief Nursing Officer (CNO) who is ultimately responsible for sustaining the standards of nursing practice in all areas in which nurses practice. The CNO must participate on the applicant organization’s highest governing decision-making and strategic planning body for at least the 12-month period prior to the submission of written documentation required in the second phase of the appraisal process. CNO education. The CNO must possess a Master’s degree. Effective January 1, 2008, the CNO must possess either the Baccalaureate or Master’s degree in nursing.1 CNO tenure. Except in the receipt of military orders, the CNO must have been in that position for at least one year at the time of the submission of the organization’s written documentation and must remain in that position throughout the appraisal process. Standards for Nurse Administrators. Applicant organizations must have the American Nurses Association’s Scope and Standards for Nurse Administrators (ANA 2004) currently implemented throughout nursing. Protected feedback procedures. Applicant organizations must have policies and procedures that permit and encourage nurses to confidentially express their concerns about their professional practice environment without retribution. Policies and procedures that discourage nurses to express their concerns about their professional practice environment are prohibited. Unfair labor practices. In the three-year period preceding submission of the application, the applicant must not have committed an unfair labor practice involving a nurse; as determined in a fully and finally adjudicated proceeding or before the National Labor Relations Board (NLRB) or state or international regulatory agency with jurisdiction over labor relations and/or a reviewing federal, state, or international court;. Only the Commission on Magnet may approve any exception to this criterion.2 Regulatory compliance. Applicant organizations must be in compliance with all applicable local, state, and federal laws, regulations, statutes, and accrediting body standards, including the practices recommended in the National Patient Safety Goals. The latter includes: Improve the accuracy of patient identification. Improve the effectiveness of communication among caregivers. Improve the safety of using medications. Improve the safety of using infusion pumps. Reduce the risk of health acquired infections. Accurately and completely reconcile medications and other treatments across the continuum of care. Reduce the risk of patient harm resulting from falls. Reduce the risk of surgical fires. Data collection. Applicants for Magnet designation must collect specific nurse-sensitive quality indicators (identified in the Magnet manual) at the unit level and benchmark that data against a database at the highest/broadest level possible (i.e., national, state, specialty organization, regional, or system) to support research and quality improvement initiatives.3 Notes: 1. Master’s-level preparation for Chief Nursing Officers may be in progress at the time of initial application but must have been completed by the time the applicant submits its written documentation. 2. Contact the Magnet Recognition Program® office for instruction on requesting an exception to the criterion; click here for a list of responses you will be expected to provide. 3. Applicants must have been collecting such data at least one year prior to submitting written documentation. System eligibility requirements (Appendix E of Magnet Application manual) Applicants applying as a system must meet each of the following requirements in addition to the requirements listed in Chapter 3. 1. Quality of nursing leadership There must be one CNO for entire system. Each component entity shall have a designated RN executive leader who: 1. is prominently responsible for nursing service at that entity, 2. has detailed knowledge and control over the day-to-day operations of the clinical practice of nursing within that entity, and 3. Meets the CNO educational and tenure requirements. 2. Organizational structure There must be one CEO for the entire system. There must be a single governing board for the entire system. The same shared governance mechanism must be operationalized throughout the entire system. 3. Management style There must be an established nursing council/committee in which representatives from all component entities participate in shared decision making and developing strategy for system-wide nursing initiatives. 4. Personnel policies and programs The same performance appraisals must be used throughout the system. The same pay practices must be used throughout the system. The same policies and procedures must be used throughout the system. The same policies support career development and advancement must be used throughout the system. 5. Professional models of care The same model of care must be used throughout the system. The same philosophy must be used throughout the system. Same state Nurse Practice Act must govern all component entities of the system. 6. Quality of care The same clinical documentation system(s) must be used throughout the system to support integration of research and evidence-based practice into clinical and operational processes. 7. Quality improvement The same performance improvement methodology/structure must exist throughout the entire system. 8. Consultation and resources The same support for nursing research, to include personnel and finance, must exist throughout the entire system. 9. Autonomy The same credentialing and privileging process for advanced practice nurses must exist throughout the entire system. 10. Community and the healthcare organization There must be system-wide nursing participation in a community advisory committee. There must be system-wide nursing participation in community sponsored events. 11. Nurses as teachers There must be an integrated nursing education department serving the entire system. There must be an established system-wide patient and family education committee. 12. Image of nursing There must be system-wide marketing and integration of publications that are promoted to the community and nursing staff. 13. Interdisciplinary relationships The same policies and procedures governing interdisciplinary relationships must be applied across the entire system. 14. Professional development The same educational opportunities, to include orientation, certification, clinical ladders, and financial support in budget, must exist across the entire system. Magnet Recognition Program® Fee Schedule (Effective April 1, 2003, for all applications received after that date) The following fee schedule is applicable to organizations in the United States. The Magnet Recognition Program® reserves the right to change these fees as it deems necessary. Please check this site regularly for updates. Applicant organizations outside the United States are encouraged to call the Magnet Recognition Program® Office to inquire about fees applicable to their setting. Application Fee: $2,500. This is the only fee submitted at the time of application. Appraisal Fees (submitted when the written documentation is mailed): Acute Care In-patient Settings Long-Term Care In-patient Settings Bed Size Appraisal Fee Bed Size Appraisal Fee 100 or less $9,765 50 or less $3,700 101-299 $12,075 51-100 $4,800 300-399 $21,000 101-150 $6,000 400-499 $30,450 151-200 $7,000 500-749 $39,375 201-350 $8,000 750-949 $47,250 351-500 $10,000 $47,250 + $50 $10,000 + $20 950+ 501+ per bed over 949 per bed over 500 Ambulatory/Out-patient Settings, including home care and hospice organizations (submitted when the written documentation is mailed): $15,000 if applying as an individual entity $4,500 plus the inpatient fee if applying in conjunction with an in-patient facility Appraiser Honorarium: $1,000 per appraiser. The applicant will be invoiced for this amount during the review of the written documentation by the team of appraisers. (Usually there are two appraisers per application. However, large organizations could require additional appraisers.) Site Visit Fee: $1,500 per day per appraiser. The applicant will be invoiced for this amount after the site visit dates have been agreed upon. (Site visits usually require two appraisers for at least two full days. However, large health care organizations, health care systems, and health care organizations with multiple sites could require more appraisers and/or more visit days. In addition, there are travel/lodging and other related expenses for the site visit. The applicant organization is responsible for paying these expenses.) Re-designation Fees. These are submitted as described above. The applicant does not pay an application fee for the re-designation process. Appraisal fees for re-designation are 50% of the current appraisal fees for initial designation. Appraiser honorariums (for document review) apply according to the current rate as stated above. Thursday, December 1, 2005 7:00 AM - 8:00 AM Registration and Continental Breakfast 8:00 AM - 9:00 AM Welcome & Overview of Workshop ANCC Structure, Function and Resources History of Magnet Concept Magnet Video: "Profiles in Excellence" 9:00 AM - 10:00 AM Journey to Excellence Presentation by Magnet Facility CNOs 10:00 AM - 10:15 AM BREAK 10:15 AM - 12:15 PM Organizational Readiness, Support and Application Process Gauging Organizational Readiness Organizational Support & Communication Plan Navigating the Application Process 12:15 PM - 1:00 PM Networking LUNCH 1:00 PM - 2:30 PM Co-Host Panel Presentations Journey to Excellence Best Practices Evidence Based Practice 2:30 PM - 2:45 PM BREAK 2:45 PM - 4:30 PM Fourteen Forces of Magnetism: Expectations, Components and Sources of Evidence Friday, December 2, 2005 7:00 AM - 8:00 AM Registration and Continental Breakfast 8:00 AM - 10:00 AM Fourteen Forces of Magnetism: Expectations, Components and Sources of Evidence Magnet Video "The Standard for Quality Patient Care" 10:00 AM - 10:15 AM BREAK 10:15 AM - 12:00 PM Fourteen Forces of Magnetism: Expectations, Components and Sources of Evidence 12:00 PM - 1:00 PM Networking LUNCH 1:00 PM - 2:30 PM Small Group Work Facilitated by: * Magnet Facility * ANCC Consultant * ANCC Staff 2:30 PM - 2:45 PM BREAK 2:45 PM - 4:00 PM Preparing for Appraiser Site Visit; Questions & Answers; Workshop Evaluation Current Magnet Hospitals State Facility Designated Re-Designated Expires Alabama The University of Alabama Hospital Mar-02 Mar-06 Alaska Alaska Native Medical Center Jun-03 Jun-07 Arizona Banner Good Samaritan Medical Center Jun-05 Jun-09 John C. Lincoln Hospital - North Mountain Dec-04 Dec-08 University Medical Center Jun-03 Jun-07 California Scripps Memorial Hospital La Jolla May-05 May-09 Cedars-Sinai Medical Center Jan-00 May-04 May-08 UCLA Medical Center Oct-05 Oct-09 Children' s Hospital Central California Apr-04 Apr-08 Hoag Memorial Hospital Presbyterian Oct-05 Oct-09 University of California, Davis, Medical Center Apr-97 Nov-01 Nov-05 University of California, Irvine Medical Center Jul-03 Jul-07 Colorado The Children's Hospital Oct-05 Oct-09 University of Colorado Hospital Jan-02 Jan-06 Craig Hospital Aug-05 Aug-09 Poudre Valley Hospital Jun-00 Jun-04 Jun-08 Connecticut Hartford Hospital Jan-04 Jan-08 Middlesex Hospital Jun-01 Aug-05 Aug-09 Stamford Hospital Sep-05 Sep-09 District of Columbia Georgetown University Hospital Jan-04 Jan-08 Florida Morton Plant Mease Hospital Jul-03 Jul-07 Dunedin Hospital Jul-03 Jul-07 Mease Countryside Hospital Jul-03 Jul-07 Morton Plant NorthBay Hospital Jul-03 Jul-07 Holy Cross Hospital Sep-03 Sep-07 Shands at the University of Florida Oct-03 Oct-07 Holmes Regional Medical Center Jul-03 Jul-07 Baptist Hospital Apr-98 Jul-02 Jul-06 Miami Children's Hospital Jul-03 Jul-07 South Miami Hospital May-04 May-08 Palm Bay Community Hospital Jul-03 Jul-07 Sarasota Memorial Hospital Mar-03 Mar-07 James A. Haley Veterans' Hospital Mar-01 Apr-05 Apr-09 Tampa General Hospital Jun-05 Jun-09 Georgia Saint Joseph's Hospital of Atlanta Nov-95 May-00/May-04 May-08 University Hospital Apr-05 Apr-09 Medical Center of Central Georgia May-05 May-09 St. Joseph's/Candler Jan-02 Jan-06 Idaho St. Luke's Regional Medical Center Dec-01 Dec-05 Illinois Children's Memorial Medical Center Dec-01 Dec-05 Rehabilitation Institute of Chicago Aug-05 Aug-09 Rush University Medical Center Jun-02 Jun-06 Delnor-Community Hospital Feb-04 Jan-08 EDWARD Hospital & Health Services Aug-05 Aug-09 Advocate Christ Medical Center Apr-05 Apr-09 Advocate Lutheran General Hospital Aug-05 Aug-09 Methodist Medical Center of Illinois Aug-04 Aug-08 OSF Saint Francis Medical Center Nov-04 Nov-08 OSF Saint Anthony Medical Center May-05 May-09 Indiana Columbus Regional Hospital Jul-03 Jul-07 Goshen General Hospital Nov-04 Nov-08 Indiana University Hospital Oct-04 Oct-08 Methodist Hospital Oct-04 Oct-08 Riley Hospital for Children Oct-04 Oct-08 LaPorte Regional Health System Oct-04 Oct-08 Iowa Alegent Health Mercy Hospital Jul-05 Jul-09 Genesis Medical Center, Davenport Oct-05 Oct-09 Mercy Medical Center Nov-04 Nov-08 University of Iowa Hospitals and Clinics Jan-04 Jan-08 Kentucky Central Baptist Hospital Oct-05 Oct-09 University of Kentucky Hospital Oct-01 Oct-05 Oct-09 Jewish Hospital Oct-01 Oct-05 Louisiana Lafayette General Medical Center Jun-03 Jun-07 East Jefferson General Hospital Jul-02 Jul-06 Ochsner Clinic Foundation Sep-03 Sep-07 Maine Acadia Hospital Jul-03 Jul-07 Maryland The Johns Hopkins Hospital Nov-03 Nov-07 Massachusetts Dana-Farber Cancer Institute Jun-05 Jun-09 Massachusetts General Hospital Sep-03 Sep-07 Jordan Hospital Jan-05 Jan-09 Baystate Medical Center Oct-05 Oct-09 Winchester Hospital Nov-03 Nov-07 Michigan William Beaumont Hospital Jan-04 Jan-08 Minnesota Mayo Clinic College of Medicine Feb-97 Jun-02 Jun-06 St. Cloud Hospital Jun-04 Jun-08 Missouri Southeast Missouri Hospital Sep-04 Sep-08 Boone Hospital Center Apr-05 Apr-09 Children's Mercy Hospitals and Clinics Jan-03 Jan-07 St. Joseph Medical Center Jun-04 Jun-08 Saint Luke' s Hospital Oct-04 Oct-08 Barnes-Jewish Hospital Oct-03 Oct-07 St. Louis Children's Hospital Oct-05 Oct-09 Nebraska Saint Elizabeth Regional Medical Center Jun-04 Jun-08 Nebraska Methodist Hospital Apr-04 Apr-08 New Hampshire Dartmouth-Hitchcock Medical Center Dec-03 Dec-07 St. Joseph Hospital Apr-05 Apr-09 New Jersey AtlantiCare Regional Medical Center Mar-04 Mar-08 Medical Center of Ocean County Jun-98 Aug-02 Aug-06 Englewood Hospital & Medical Center Jun-02 Jun-06 Hackensack University Medical Center Feb-95 Mar-99/Mar-03 Mar-07 Kimball Medical Center Apr-02 Apr-06 Morristown Memorial Hospital Apr-01 Jun-05 Jun-09 Jersey Shore Medical Center Jan-98 May-02 May-06 Robert Wood Johnson University Hospital Nov-97 Jan-02 Jan-06 St. Peter's University Hospital Feb-98 Jun-02 Jun-06 Raritan Bay Medical Center Oct-04 Oct-08 Saint Joseph's Regional Medical Center Apr-99 Sep-03 Sep-07 Medical Center of Ocean County Riverview Medical Center Jun-98 Dec-02 Dec-06 The Valley Hospital Dec-03 Dec-07 Community Medical Center Mar-03 Mar-07 Capital Health System Mar-02 Mar-06 St. Francis Medical Center Mar-00 Mar-04 Mar-08 New York St. Peter's Hospital May-05 May-09 F.F. Thompson Hospital Nov-04 Nov-08 Mary Imogene Bassett Hospital Feb-04 Feb-08 Elmhurst Hospital Center Aug-05 Aug-09 Huntington Hospital May-04 May-08 North Shore University Hospital Dec-01 Dec-05 Hospital for Special Surgery Dec-02 Dec-06 NYU Medical Center Apr-05 Apr-09 The Mount Sinai Hospital Aug-04 Aug-08 Rochester General Hospital Sep-04 Sep-08 University of Rochester Medical Center/ Strong Memorial Hospital Aug-04 Aug-08 Highland Hospital Aug-04 Aug-08 Golisano Childrens Hospital Aug-04 Aug-08 The Saratoga Hospital Sep-04 Sep-08 St. Joseph's Hospital Health Center Nov-02 Nov-06 North Carolina NorthEast Medical Center Sep-02 Sep-06 Moses Cone Health System Feb-05 Feb-09 Pitt County Memorial Hospital May-04 May-08 Catawba Valley Medical Center May-01 Jul-05 Jul-09 High Point Regional Health System Jun-01 Apr-05 Apr-09 New Hanover Regional Medical Center (NHHN) Jun-03 Jun-07 Forsyth Medical Center Jan-04 Jan-08 North Carolina Baptist Hospital of Wake Forest University Baptist Medical Center Apr-99 Jul-03 Jul-07 Ohio The Cleveland Clinic Foundation Jun-03 Jun-07 Columbus Children's Hospital Apr-05 Apr-09 Grant Medical Center Aug-05 Aug-09 The Ohio State University Hospital Feb-05 Feb-09 Miami Valley Hospital Jun-04 Jun-08 Kettering Medical Center Oct-05 Oct-09 Kettering Medical Center-Kettering Oct-05 Oct-09 Kettering Medical Center-Sycamore Oct-05 Oct-09 Kettering Hospital Youth Services Oct-05 Oct-09 Upper Valley Medical Center Oct-03 Oct-07 St. Joseph Health Center of Humility of Mary Health Partners Aug-02 Aug-06 St. Elizabeth Health Center of Humility of Mary Health Partners Aug-02 Aug-06 Oklahoma Mercy Health Center Apr-05 Apr-09 Oregon Providence Portland Medical Center Jun-05 Jun-09 Providence St. Vincent Medical Center Nov-00 Nov-04 Nov-08 Pennsylvania Abington Memorial Hospital Jul-03 Jul-07 Lehigh Valley Hospital and Health Network Aug-02 Aug-06 Lancaster General Hospital Sep-02 Sep-06 Bryn Mawr Hospital Oct-05 Oct-09 Lankenau Hospital Oct-05 Oct-09 Paoli Hospital Oct-05 Oct-09 Bryn Mawr Rehab Hospital Oct-05 Oct-09 Children's Hospital of Philadelphia Feb-04 Feb-08 Fox Chase Cancer Center Aug-00 Aug-04 Aug-08 Rhode Island Newport Hospital Nov-04 Nov-08 The Miriam Hospital Jan-98 Feb-02 Feb-06 South Dakota Avera McKennan Hospital & University Health Center Jun-01 Jun-05 Jun-09 Sioux Valley Hospital USD Medical Center Dec-03 Nov-07 Tennessee Johnson City Medical Center of Mountain States Health Alliance Jan-05 Jan-09 Texas Brackenridge Hospital of the SETON Healthcare Network Nov-02 Nov-06 Children's Hospital of Austin, SETON Healthcare Network Nov-02 Nov-06 Seton Medical Center of the SETON Healthcare Network Nov-02 Nov-06 Seton Northwest Hospital of the SETON Healthcare Network Nov-02 Nov-06 Baylor University Medical Center Jan-04 Jan-08 Medical City Dallas Hospital and Medical City Children's Hospital Dec-03 Dec-07 Harris Methodist Fort Worth Hospital Feb-04 Feb-09 The University of Texas Medical Branch May-05 May-09 The Methodist Hospital Jul-02 Jul-06 Michael E. DeBakey VA Medical Center Aug-04 Aug-08 St. Luke's Episcopal Hospital May-01 May-05 May-09 Texas Children's Hospital Jan-03 Jan-07 The University of Texas M.D. Anderson Cancer Center Dec-01 Dec-05 Vermont Southwestern Vermont Medical Center Mar-02 Mar-06 Virginia Inova Fairfax Hospital Jan-97 Dec-01 Dec-05 Centra Health, Incorporated Aug-05 Aug-09 Lynchburg General Hospital Aug-05 Aug-09 Virginia Baptist Hospital Aug-05 Aug-09 Carilion Medical Center Nov-03 Nov-07 Washington University of Washington Medical Center May-94 May-98/Jul-02 Jul-06 West Virginia West Virginia University Hospitals Oct-05 Oct-09 Wisconsin St. Mary’s Hospital Medical Center Apr-02 Apr-06 Saint Joseph's Hospital/Ministry Health Care Aug-05 Aug-09 Children's Hospital of Wisconsin Jul-04 Jul-08 Aspirus Wausau Hospital Feb-05 Feb-09 Aurora Medical Center - Washington County Jan-01 Apr-05 Apr-09 Aurora Sinai Medical Center Jan-01 Apr-05 Apr-09 St. Luke's Medical Center Jan-01 Apr-05 Apr-09 St. Luke's South Shore Jan-01 Apr-05 Apr-09 West Allis Memorial Hospital Jan-01 Apr-05 Apr-09 Australia Princess Alexandra Hospital Health Service District Jan-05 Jan-09 The 14 Forces of Magnetism - Team Descriptions The core of the Magnet Recognition Program Force 1: Quality of Nursing Leadership Nursing leaders are perceived as knowledgeable, strong risk takers who follow an articulated philosophy in the day-to-day operations of the nursing department. Nursing leaders also convey a strong sense of advocacy and support on behalf of the staff. Force 2: Organizational Structure Organizations are characterized as flat, rather than tall, structures in which unit-based decision- making prevails. Nursing departments are decentralized, with strong nursing representation evident in the organizational committee structure. The nursing leader serves at the executive level of the organization, and the Chief Nursing Officer reports to the executive level. Force 3: Management Structure Organization and nursing administrators use a participative management style, incorporating feedback from staff at all levels of the organization. Feedback is characterized as encouraged and valued. Nurses serving in leadership positions are visible, accessible and committed to communicating effectively with staff. Force 4: Personnel Policies and Programs Salaries and benefits are characterized as competitive. Rotating shifts are minimized, and creative and flexible staffing models are used. Personnel policies are created with staff involvement, and significant administrative and clinical promotional opportunities exist. Force 5: Professional Models of Care Models of care are used that give nurses the responsibility and authority for the provision of patient care. Nurses are accountable for their own practice and are the coordinators of care. Force 6: Quality of Care Nurses perceive that they are providing high-quality care to their patients. Providing quality care is seen as an organizational priority, as well, and nurses serving in leadership positions are viewed as responsible for developing the environment in which high quality care can be provided. Force 7: Quality Improvement Quality improvement activities are viewed as educational. Staff nurses participate in the quality improvement process and perceive the process as one that improves the quality of care delivered within the organization. Force 8: Consultation and Resources Adequate consultation and other human resources are available. Knowledgeable experts, particularly advanced practice nurses, are available and used. In addition, peer support is given within and outside the nursing division. Force 9: Autonomy Nurses are permitted and expected to practice autonomously, consistent with professional standards. Independent judgment is expected to be exercised within the context of a multidisciplinary approach to patient care. Force 10: Community and the Healthcare Organization Organizations that are best able to recruit and retain nurses also maintain a strong community presence. A community presence is seen in a variety of ongoing, long-term outreach programs. These outreach programs result in the organization being perceived as a strong, positive and productive corporate citizen. Force 11: Nurses as Teachers Nurses are permitted and expected to incorporate teaching in all aspects of their practice. Teaching is one activity that reportedly gives nurses a great deal of professional satisfaction. Force 12: Image of Nursing Nurses are viewed as integral to the organization’s ability to provide patient care services. The services provided by nurses are characterized as essential by other members of the healthcare team. Force 13: Interdisciplinary Relationships Interdisciplinary relationships are characterized as positive. A sense of mutual respect is exhibited among all disciplines. Force 14: Professional Development Significant emphasis is placed on orientation, in-service education, continuing education, formal education and career development. Personal and professional growth and development are valued. In addition, opportunities for competency-based clinical advancement exist, along with the resources to maintain competency.