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Melanie Cole (Host): Carle Foundation Hospital launched its first Magnet journey as a strategy to improve nurse recruitment and retention. My guest to tell us about this, is Faith Roberts. She’s the Executive Director of Magnet Professional Practice and Parish Nursing at the Carle Foundation Hospital. Faith tell us a little bit about the Magnet designation. What is that for a hospital?

Faith Roberts, MSN, RN (Guest): It’s through the American Nurses Credentialing Center and holding that designation in the United States means that you are in the top 7% for patient outcomes and nurse satisfaction. Obviously, this is two things that we really wanted to focus on was to in a time of a nursing shortage, keep our nurses and by putting certain processes in place; we made their professional practice something that kept them here at Carle which was important and we are very proud of the fact that we are in the top 7% of the United States for high quality outcomes in CAUTI, CLABSI, falls with injury and prevention of skin breakdown.

Host: Tell us a little bit about the parameters. What does it show that a hospital system’s nurses can accomplish?

Faith: First and foremost, for us, it is continuing the education of the professional nurse. We are presently at a 67% BSN rate. Before we had Magnet, we were at 80% associate degree nurses. So, we are pleased with how many have gone on to school and that was of course, by Carle offering tuition assistance, not reimbursement. We don’t make anyone go pray by the mail box they get the check before they start the class and that has been a huge impact on people going back to school.

Second, is professional certification in their specialty. You have to be a nurse in the area for two years of practice and once you have done that, you can take an exam. That has been proven and we’ve seen it at Carle to improve nurse-physician relationships because physicians are more confident in the care being given on different units when there’s a high certification rate. Because the nurses have been on the floors and know those patients well.

Host: And that’s a great explanation into my next question about the benefits for patients, nurses and physicians. You explained a little bit about the physicians’ benefit that they can feel a little more confident now and that they know that their nurses are highly qualified. Tell us about some of the benefits for the nurses themselves and for patients. What difference would they notice?

Faith: For patients, hands down, it is the quality indicators. While they may not know what a quality indicator is; their chance of getting an infection from a catheter or a central line is very low at Carle compared to the rest of the country. Chances of falling are low at Carle. Skin breakdown, low at Carle. We are not perfect. We do, at times, have issues with these quality indicators, but when you are Magnet; what you say is, okay that happened, what are we going to do about it versus old school thinking of well that’s the way it goes.

For nurses, I think our engagement scores continue to climb as we prepare for this visit. One of the reasons that they are coming is that our nurse engagement scores were some of the highest in the United States. Our nurses feel like their opinions are valued through the daily white board rounds with the physicians. And because of that, our patients are getting home and getting out of here sooner because there is a shared discussion at the white board every single day of the week about who needs to go home and how do we get them ready to go home. And before, maybe different disciplines had their own dates in mind, now it’s a shared discussion and we get our patients home sooner, which makes everyone happier.

Host: Faith, how tough is this to get and what is the evaluation involved? What does that look like?

Faith: Magnet it not easy. It’s one of our sources of pride, not only that we received it once, twice and now we are going for our third. Because the actual standards change every time. It’s not like accreditation where you have standards you have to meet every year, and everyone knows the standards by heart.

Every four years, they send out a new set of standards and they get harder because ANCC the American Nurses Credentialing Center, wants to make sure that Magnet remains the crème de la crème, the top echelon. And so, our expectations get tighter every time, but for us here at Carle, that’s good. We like showing that we can hit it and keep it. I think that getting Magnet is a huge accomplishment. Keeping Magnet is tough. You must have shared governance. The person closest to the patient should have a voice in how things will be done, and we have nursing research here that is phenomenal.

Most places center on medical research only and Carle is open to translational research, medical research, nursing research and having an environment where research is encouraged, is huge. So, we sit together with the team and we look at the standards and we write to them. And the document is 2120 pages long, where we showcase what Carle nurses can do. Our documents were accepted and went what we call straight to site-visit. Only 20% of the documents in the United States go straight to site-visit. So, we are very proud of that accomplishment.

January 28^th, 29^th and 30^th, three appraisers who are working, chief nursing officers at other facilities, will come and they will go around the building and talk to our physicians and our staff and the patients. And what they are here for, the words they use are verify, amplify and clarify what we had in the documents. In other words, is what they wrote, really happening here? And a huge part of that is they will have meals three times a day with random pulls of nurses and before they leave, they will have talked individually to over 400 nurses, which is a great way to validate your care.

Host: Wow a lot goes into it. So, tell us a little bit about the hospital retains its Magnet status; what would you like incoming nurses to know about respect, dedication and working for a Magnet Designated hospital?

Faith: Well, the Magnet Designation is both for the hospital and Carle Physician Group Clinic, so it includes ambulatory and acute nurses. We will – Human Resources recruiting is adamant that when people come here; we explain to them, you will be a part of Magnet. You are not a sit on the sidelines and watch it. You will be part of shared governance. You will be asked to go back to school if you need to. We will pay for your certification. No one has to pay for that. We pay for that. And so, they set the – I would say kind of like the guidelines. But once they get in, it’s – in the comments in our last employee engagement survey, several of the new nurses wrote about they came here as students and they always thought I want to be a Carle nurse. I think Magnet brings a sense of pride to the practice. And that’s something that we treasure here at Carle. I will say that for the last nine years, new physicians coming to Carle many times come from Magnet facilities and in their interviews, they will ask if we are Magnet, because they know that the level of nursing will be at a higher scale.

Host: Faith, thank you so much for being on with us today and explaining this very important designation. Thank you for all the great work that you are doing. You’re listening to Expert Insights with the Carle Foundation Hospital. For a listing of Carle providers and to view Carle sponsored educational activities; please visit www.carleconnect.com, that’s www.carleconnect.com. We hope the information gained will be applicable to your work and life. This is Melanie Cole. Thanks so much for tuning in.