Engaging staff in the Magnet® journey: the key is communication

Engaging staff in the Magnet® journey: the key is communication

Peg Pierson

Nursing leadership at Saint Elizabeth Regional Medical Center in Lincoln, Nebraska, recognized from the outset that a successful bid to achieve designation as a Magnet[R] hospital would hinge upon the ability to engage staff and other stakeholders in the process. Leaders believed that ongoing positive communication would be the key, and they now recognize they were right.

They have received numerous requests from other facilities for guidance in establishing an internal communication plan. Their highly structured communication plan identified the following tasks and objectives:

* Plan and organize.

* Identify stakeholders/audiences for the messages.

* Articulate your goals.

* Communicate visibly.

* Define a tagline and/or logo.

* Help others communicate the messages.

* Keep the messages alive.

* Re-evaluate periodically.

* Celebrate along the way.

* Use variety in delivering messages.

These strategies are outlined for anyone choosing a similar path.

Planning and Organization

Even as they considered the Magnet application, leaders recognized the need to provide the right information to the right audiences at the right time. The communication plan was quite informal during the decision-making stage because the target audiences were few in number and easily identified. Having secured the support of the administrative team to undertake the rigorous process required to pursue Magnet designation, they began to shape well-articulated steps with timelines to meet a rather aggressive self-imposed deadline for document submission.

Nursing leadership quickly galvanized, demonstrating its synergy, and chose to pursue a staff-assumed management approach spearheaded by the professional nurse practice council (PNPC) to identify, gather, and write the critical documentation required for this pursuit. PNPC, an all-RN shared leadership council with representation from all practice settings within the facility, already met monthly and was ideal to serve as the overall Magnet steering committee. Fourteen teams were formed, consisting of staff RNs, nursing leaders, and occasional non-nurses to develop the narrative for each one of the Standards (now Forces). Simultaneously they determined that the chief nursing officer (CNO) and the Magnet coordinator would collaborate with the public relations/marketing staff to devise an internal communication plan.

Identify Stakeholders

Each unique stakeholder (board members, physicians, in-house staff, etc.) was defined. The formal communication plan identified strategies and communication timelines for each stakeholder/audience. The appropriate communication tools (newsletter, email, etc.) for each audience was identified as well as the purpose, need, and frequency of using the best tools to achieve maximum effect. Responsibility was designated for each task and a timeline was set and articulated in a Guidelines and Process document (see Figure 1).

Articulate Your Goals

In communicating, it is crucial to identify and articulate goals to keep messages on track to appropriate audiences. The following goals were identified:

* Promote hospital-wide awareness of the Magnet program, the fact that the nursing department was applying for said status, and the value to the facility and all personnel in doing so.

* Keep all stakeholders (not just nursing) informed and updated as to the progress throughout the process.

* Educate and engage clinical staff as to their role in this process and the anticipated ultimate success.

* Overcome areas of hesitancy or reticence on the part of staff, physicians, or other stakeholders, and replace them with enthusiasm and support.

Communicate Visibly

Each exposure to Magnet communication materials was an opportunity to inform. To maximize the impact of those exposures, a set of communication principles were devised.

* All communication would have a consistent look to be achieved through development of a logo and tagline unique to the organization and reflective of the corporate culture, and a newsletter with a consistent and recognizable format.

* All messages would identify and/or delineate the value of pursuing Magnet designation for the entire organization and all stakeholders.

* It was critical to the corporate culture that messages of the Magnet quest go beyond nursing, emphasizing that all stakeholders were part of the team striving to provide an excellent patient experience, that nursing does not function in a vacuum, and that excellent service depends upon collaboration as one of the Forces of Magnetism.

Tagline and Logo

Magnet logos observed in the literature were impressive and varied. A logo was created that reflected the culture of the organization and captured concepts that symbolized the organization in its Magnet journey logo. A design embodying a compass (representing the journey and guidance) was selected along with the tagline: We encompass everything positive on our way to becoming a Magnet Hospital. A professional sketch of the new patient care tower, then under construction, was also included. Each communication carried the identifiable Magnet logo, reinforcing an ongoing process. The Magnet journey logo is illustrated in Figures 2-4.

[FIGURES 3-4 OMITTED]

Help Others Communicate Your Messages

Communication tool kits were created to assist everyone in the medical center in communicating the value of designation as a Magnet facility. Included in the tool kit were a set of Talking Points and Frequently Asked Questions, which were distributed to each department head and nursing leader (see Figure 2). These helped keep messages clear, concise, and consistent. Public relations staff edited and adjusted these messages, keeping them positive, focused, and conversational in tone. One key message that was very effective was that stakeholders already believed we were a “Magnet-like” facility and that pursuit of Magnet status was a celebration of the work done every day.

Keep the Messages Alive

To communicate successfully over the long-term, deciding on the venue and key communication players are vital. A monthly one-page newsletter Magnet Directions (the title building on the compass included in the Magnet journey logo) became the primary in-house communication tool. During the planning process, the value of a small working committee to keep the information fresh and on-target was identified. Thus the communication committee met monthly. Those meetings were scheduled to follow each month’s PNPC meeting so that group could serve as a message guide. The communication committee comprised the CNO, Magnet coordinator, and a PR staff member (chief writer/communication coordinator). Including only those personnel essential to deciding and shaping the newsletter’s content provided the most effective and efficient way to retain focus and meet the established timelines. A rapid proofing process was also developed. The Magnet coordinator and CNO signed-off on content (which was sent via email) to speed up the publishing process. Newsletters were produced entirely in-house, contributing to a more efficient, cost-effective, and timely process.

Re-Evaluate Periodically

Communication strategies and tools were evaluated continually throughout the process, both within the communication committee and the Magnet steering committee, and changes were made as needed. For example, a weekly email Magnet Briefs was added to target just nurses with short two or three-sentence messages describing how each of the 14 Forces of Magnetism were being met. These communications helped nurses become knowledgeable about the requirements and process for achieving the coveted Magnet award and also contributed to their engagement. Each email encouraged recipients to contact the CNO or Magnet coordinator if they had questions or comments.

Celebrate Along the Way

The idea of celebrating along the way came from the PNPC, but it has since become an integral tool in all long-term communication plans. Celebrations took two forms. Monthly Celebrate! picture posters (see Figure 3) were attractively matted, framed, and hung in each clinical area of the medical center. These posters were designed to reflect upon the successes and to celebrate professional excellence. The posters communicated the different Forces of Magnetism and, using facility staff, illustrated how those forces were demonstrated. Monthly newsletters and the Celebrate! posters were posted in public areas rather than behind the scenes. An unanticipated benefit of this was realized when patients and visitors would stop to view the Celebrate! posters. These posters became a means of educating the community about the Magnet award and its meaning, and the benefits to the community of having a local Magnet facility. The concept was not well known in the region because this was the first facility in the state to apply for this prestigious status. It was exciting to the staff when a visitor or patient would express enthusiasm over the posters because they knew of the Magnet award or had previously lived in a community with a Magnet hospital.

Use Variety in Delivering Messages

During the months worked to compile the documents, messages were delivered by a variety of methods to stakeholders. Some were verbal and delivered spontaneously or prearranged, others were printed or delivered via email, and others were displayed visually in posters or newsletters. The committee was prepared to answer questions or address comments adequately, and speak accurately, enthusiastically, and professionally on the subject of Magnet at any time in any venue.

Canvas tote bags, adorned with the Magnet journey logo, were distributed to the nursing staff to inaugurate the quest (see Figure 4). The timing was perfect for these totes to serve as the medical center gifts for Nurses’ Week. The totes were accompanied by a letter from the CNO thanking nurses for the excellent patient care that they provide and introducing the “traveling the positive path to Magnet” message. The totes served as excellent visual reminders of the Magnet journey and were popular with the staff long after Nurses’ Week ended.

The CNO regularly holds informal quarterly nursing forums with associates/employees. The forums occurring during Magnet preparation focused on that process and afforded opportunities to deliver updated, more complete information to the nurses while also affording opportunities for anyone to ask Magnet-related questions directly of the CNO. The forums also offered a sounding board for the CNO to discover the concerns of the staff during the Magnet journey.

Non-nursing in-house entities (for example, performance improvement, human resources, medical staff) may benefit from the Magnet messages delivered at their staff meetings, but often ask, “What’s in it for me, or my department?” It was helpful to identify appropriate communicators and anticipate these requests. Management team meetings and other multidisciplinary venues were excellent opportunities to provide updates on the Magnet process. One successful strategy was to utilize people who were eager and equipped to speak at department meetings or over lunch. This strategy was an important means of engaging non-nursing staff in the pursuit of Magnet status and an excellent means of instilling organizational pride.

Leaders should take advantage of opportunities to deliver the Magnet message outside of the facility to educate the general public, future nurses, and other professionals. Schools of nursing and professional meetings offer excellent venues. Speaking about the Magnet process was an easy task because of the enthusiasm for and commitment to the program.

Take a Breath

Celebration was encouraged each step along the way. The Magnet process is lengthy and can be exhausting. Leaders suggest having small celebration breaks upon selection of the teams to develop the documentation for each of the forces, or completion of first drafts of the narratives, and larger ones to mark the completion of the voluminous documents to be sent to the American Nurses Credentialing Center (ANCC). An “It’s A Wrap” party (the term borrowed from the movie industry to denote completion of filming) was a significant event in the journey because it marked the completion of the documentation process and “wrapping” the documents for mailing to the ANCC and the surveyors. The Wrap Party was a festive occasion; associates from across the organization were invited to view the documents, remarks were made by members of the administrative team, and they actually wrapped the documents in preparation for mailing. These celebrations helped communicate successes, respectfully reminding everyone of the hard work that goes into this process. They were very proud moments for individuals and the organization.

A communication notebook, with copies of the communication plan and all Magnet communications, was compiled and serves a useful reference, as evidence of the involvement of the associates at all levels of the organization, and demonstrates the numerous opportunities for two-way communication. This notebook was referenced during the survey to illustrate that Magnet communications occurred early and often during the preparation phase.

The Wait

After the flurry to finalize the documents for mailing to the ANCC, there is a bit of a lull in activity. Leaders spoke of being cautiously optimistic during the weeks that followed submission. Continued positive communications were shared with stakeholders to maintain interest and enthusiasm. For example, acknowledging how proud leaders were of everyone’s contributions to the survey, reviewing highlights of the survey, sharing positive remarks from appraisers, and recounting the numbers of staff who were in contact with the appraisers.

Site Visit Preparation

After learning of the impending site visit, interest again peaked. Open information sessions were held for all staff. As many specifics as possible were shared about the upcoming survey, from information about the surveyors and the agenda for the survey, to what would be expected. These sessions were very well attended, and staff said repeatedly that they appreciated the information and felt more confident about potential survey encounters because they had a sense of what to expect.

Shortcomings

Leaders realized there was a group of stakeholders with whom communication could have been better–physicians. Few of the physicians had previous exposure to the Magnet concept because there were no Magnet facilities in the community or even in the state at the time of the survey. The plan defined communication with physicians at staff meetings and through newsletters. However, these strategies were not very effective with an audience already bombarded with information. Some physicians were involved in the documentation and those few were well informed of the process due to one-on-one dialogues. Messages to this audience would probably be more productive if delivered personally during the work day, most often by nurses on the clinical units and with whom the physicians had established working relationships.

‘Nurse Speak’

From the public relations perspective, a true partnership developed from the Magnet communication collaboration. Because the public relations department was a small group, only one staff person was involved on an ongoing basis. That person certainly has long respected nurses’ dedication, their focus on accuracy and regular reporting, but kidded often about “nurse speak”–using clinical terminology when plain English would suffice. The challenges went beyond developing positive and enthusiastic messages to include understanding the heart of specific nursing issues and accurately translating them for non-nurses, providing condensed factual messages, and still captivating the interest and enthusiasm of all staff.

Nurses are accustomed to daily interdepartmental cooperation, but having such a close partnership with public relations was a new experience. The public relations representative was invaluable in keeping staff focused, “on message,” and assuring information addressed needs of those outside the nursing division. The author immersed herself in the Magnet literature, became very well informed in the issues surrounding nursing shortages, and emerged as a champion for nursing communication.

Sustaining

The Magnet Communication Plan continues to serve as the framework for ongoing communications with the focus now on sustaining the Magnet culture, preparing annual interim reports, and planning for the submission for redesignation in 2008. Leaders continue to communicate with all stakeholders, the logo has shifted to the Magnet logo itself (rather than the Magnet journey logo), the Magnet Directions newsletter remains a major vehicle for communicating within the organization but is published less frequently during the interim period, and communications were increased with physicians to assure a more active medical staff involvement in the next survey.

Celebrate! posters were replaced (proudly) with ANCC Magnet Recognition Award certificates. ANCC clearly articulates that what an organization does to achieve Magnet status will not be sufficient to receive redesignation; the organization must continue to excel.

Conclusion

Leaders have learned that the most effective Magnet communication results not from the number of people assigned to tasks, but from having the right person in the right place. Final words of advice are to select the team for their abilities. A successful Magnet journey is the professional experience of a lifetime, and hospitals need to use their resources (time, tools, and talent) to their greatest advantage to achieve the desired goal.

Peg Pierson, MSN, RN, CNAA, BC, is Professional Nurse Practice/Magnet Coordinator, Saint Elizabeth Regional Medical Center, Lincoln, NE.

Jo Miller, BS, is Public Relations Coordinator, Saint Elizabeth Regional Medical Center, Lincoln, NE.

Kim Moore, MSN, RN, CNAA, BC, is Vice President of Nursing/Chief Nursing Officer, Saint Elizabeth Regional Medical Center, Lincoln, NE.

Note: A copy of the comprehensive communication plan is available upon request from the author: ppierson@stetz.org

Figure 1. Guidelines and Process for Initiative Communication

Saint Elizabeth Regional Medical Center

ACHIEVING MAGNET STATUS

Guidelines and Process for Initiative Communication

Communication Goals:

1. To promote hospital-wide awareness of Magnet Hospital process.

2. To keep all stakeholders informed and updated.

3. To educate and engage clinical staff.

4. To overcome areas of hesitancy or reticence on part of all

stakeholders, and replace with enthusiasm and support.

Group Objective Timeline

Professional * Oversight and implementation Meets 4th

Nurse Practice of Magnet initiative Wednesday of

Council * Identifies key communications each month

and discussion points during

each meeting for Magnet

Communication Team planning

Magnet Oversight function for project Meets 4th Friday

Communication communications: of each month

Team: CNO, * Develops and modifies following PNPC

Magnet communication plan and process. meeting

Coordinator, * Researches, creates, and

PR Coordinator refines messages for monthly

communications and determines

appropriate communication

format.

* Identifies opportunities to

engage clinical staff in

discussion and feedback related

to initiative.

PR Coordinator * Responsible for development Materials

and distribution of: distributed

–Talking Points document the first

–Monthly Magnet newsletter business day

–Physician Newsletter content of each month

PR Graphic * Develops Saint Elizabeth Magnet By 1/16/03

Artist journey logo and template for

newsletter.

Magnet * Responsible for preparing Each Wednesday

Coordinator and disseminating email

communications to RNs and LPNs

* Responds to queries

* Shares results/feedback from

communications with PNPC and

Communication Team

CNO * Reviews and approves all Ongoing

communication materials prior to

release. May defer to Magnet

Coordinator for approval.

* Presents Magnet progress at each

Management Team meeting and

Nursing Forum.

* As needed, presents at

additional meetings/events

including Senior Leadership

and Medical Staff to achieve

communication goals.

Nursing * Reviews and discusses monthly Monthly

Directors Talking Points at each

department staff meeting or in

a comparable format (i.e. weekly

director communications)

* Posts Magnet newsletter in

department onstage area.

Critical Success Factors:

The following are critical success factors for optimizing the value

of the Magnet communication plan and process:

1. Receiving thoughtful and timely information from PNPC each month.

2. Development of measurement early in process to establish reach

and effectiveness of communications.

Figure 2.

Talking Points/Frequently Asked Questions

Seeking Magnet Accreditation

Talking Points/Frequently Asked Questions

What is Magnet status?

[] Magnet accreditation grew out of the national nursing shortage and

is awarded by the American Nurses Credentialing Center (ANCC) in

Washington, DC, to help identify hospitals with an environment where

nursing professionals thrive.

[] The term Magnet refers to the ability to attract (and retain) and

is only used to designate those acute care or tertiary

care facilities that attract quality nurses and retain them.

[] The most frequently used terms Magnet hospitals use are Magnet

Hospital for Excellence in Nursing and Magnet

Hospital for Nursing Services.

[] The standards are high. Of the first 165 hospitals seeking

Magnet status, only 41 could meet the more than 95

very specific criteria. About 50 facilities a year apply.

[] All criteria must be well documented. They include such areas

as associate satisfaction, quality improvement reports, recruitment

and retention strategies, quality of leadership, professional

models of care, quality of care, interdisciplinary relationships,

professional development, and much more!

Who supports this at Saint Elizabeth?

[] Our administrators, directors, and PNPC (representing nursing

staff) recognized this as an excellent opportunity for Saint

Elizabeth to gain recognition for the many positive programs and

services we provide–and especially for our culture of excellence

that promotes a healing environment for our patients and a

supportive workplace for our associates.

[] When we first expressed an interest in seeking this prestigious

designation, the excitement and support began building immediately

throughout the medical center.

[] We want and need the support of every associate at the

medical center to be successful–it takes all of us working

together to achieve our successes.

Who all will be involved?

Everyone–this will affect every one of us at the medical center!

While our approximately 600 nurses will lead the way in seeking

this accreditation with PNPC as the steering committee, we

learned from our Embrace the Spirit service excellence program

that it takes all of us–from every department–to deliver

excellent patient care! So we will all have roles to play in

achieving this accreditation and we will all be able to share

in the pride if we attain it.

Why do we want Magnet accreditation?

[] We are seeking this prestigious accreditation because at Saint

Elizabeth our #1 goal is excellent patient care–this can be

viewed as a stamp of excellence.

[] Meeting the criteria of a Magnet hospital would demonstrate that

we clearly provide excellent patient care through a program that

also supports the professionalism of our nursing team and other

medical staff as well as the role of each and every associate who

contributes to our ongoing success!

[] We know Magnet status will make us extremely attractive to the

highest quality nursing staff and during a nursing shortage that

is no small consideration.

[] We also recognize that by obtaining Magnet status we will be

viewed within our community as among the most respected health

care providers in the nation!

How will we know what we’re supposed to do?

[] PNPC, as the steering committee, will be key players in keeping

nursing staff informed.

[] Directors and others will ask you directly if you are needed to

assemble necessary information or documentation.

[] There will be a monthly newsletter (Magnet Directions) in all

departments directed to all associates within the medical center.

[] MOXmails will serve as reminders or to direct nursing staff to

more detailed infonnation; directors will receive e-mails.

[] Your director or supervisor will provide you with periodic updates.

COPYRIGHT 2007 Jannetti Publications, Inc.

COPYRIGHT 2007 Gale Group