November 2024

Congratulations to Our Recent Magnet® Designees!

It brings us joy each issue to share news of our partners achieving their well-earned Magnet^® Designations! The MPDs, their writers, and the nursing care team at each of these hospitals have worked so hard for this moment, not to mention all the patients who benefit from receiving Magnet^® level care. Here is a partial list of our recent designees since the last feature.

Centra Lynchburg General Hospital
The Mount Sinai Hospital
The Queen’s Medical Center
Zucker Hillside Hospital

Tipton Health Holiday Schedule Announcement

Happy Holidays from Tipton Health! We value a healthy and happy work environment, and this year, we will be scheduling Writing Support so that our team can take their time away during this busy season to celebrate with family and friends. The Tipton Health team has kept its promise to return documents in Writing Support within 30 business days for nearly two full years, and we will keep that commitment throughout 2025.

During the 2024 holiday period from December 24, 2024, to January 2, 2024, no documents will come due for return. Our team will be back to business as usual on January 3, 2025. For your documents, this means that anything submitted from November 25, 2024, to December 2, 2024, will be scheduled for return during the window of January 3, 2025, to January 9, 2025.

Essentially, when we calculate your return date, we will not be including our holiday period with the calculation. We will continue to accept document submissions during the holiday period, but we will be returning these documents at a slower pace than usual as the team takes time away to celebrate the year-end holidays.

Rest assured that Tipton Health remains committed to keeping our promises to our clients and our team. If you have questions about how the Tipton Health holiday schedule will impact your writing schedule, please reach out to your client advocate. Our team will continue to work to ensure we deliver results that support your team and deliver nursing excellence results.

Tipton Health 2024 Magnet® Conference Impressions and Learnings

The Tipton Health team was pleased to connect with many of our existing clients and the fantastic network of nurses and leaders at the 2024 Magnet^®/Pathway to Excellence^® Conference in New Orleans, LA. The energy at the conference was incredible! The conference was buzzing with excitement, especially from newer nurses attending for the first time and from those organizations being recognized for their recent designations/re-designations.

Daily conference events included keynote sessions, breakout educational sessions, poster presentations, interaction with vendors and sponsors in the exhibit hall, networking events, receptions, and professional development workshops. The conference also included a new Nurse Innovation area in the exhibit hall, where nurses shared information about the latest healthcare tech and innovations in care and practice.

Many of our valued clients made time in their busy conference schedules to stop by the Tipton Health booth to share their appreciation for our hands-on approach throughout their journey to excellence. We deeply value these conversations with our partners, and we were excited to celebrate their success as they “walked the stage” in recognition of their designation or re-designation.

At the Tipton Health booth, we asked nurses what makes them proud to be a nurse at their organization, what challenges they face, and what they hoped to take back to their organizations from the conference. A few themes emerged through these conversations. Nurses expressed pride in the care they provide for their communities, as well as the spirit of teamwork in their organizations, support for nurse research, working for organizations that prioritize nurse well-being, and participating in shared decision-making councils. Many nurses shared that their biggest challenges are still related to the COVID-19 pandemic, including burnout, staff retention and scheduling, and rebuilding culture within their units and organizations. Some of the most popular ideas and innovations nurses wanted to take back to their organizations included increasing shared governance participation, new recognition activities, nurse well-being initiatives, and technologies they learned about in the Nurse Innovation area.

In addition to connecting with our clients, we learned that the Magnet^® Program Office has updated the Year 2 Interim Monitoring Report (IMR) for Magnet^® designated organizations.

ANCC Magnet^® Program Update: Changes to the 2023 Application Manual IMR Submission Requirements

The IMR, which is due on the last day of the Magnet^®designation anniversary month in Year 2, has received two key updates.

New Requirement for Organizations with Deficiencies

Organizations designated with deficiency(ies) must now complete a PDCA (Plan-Do-Check-Act) action plan.
The PDCA template can be found in the Tables and Templates section of the Magnet^® Learning Community.

Expanded Graph Requirements

Organizations must now submit five specific graphs which meet the requirements in the manual for graph presentation.
Graph 1: RN Satisfaction/RN Engagement

Can represent any unit or ambulatory care setting

Graph 2: Inpatient Nurse-Sensitive Clinical Quality Indicator

Must represent data from any inpatient unit

Graph 3: Ambulatory Nurse-Sensitive Clinical Quality Indicator

Must represent data from any ambulatory care setting
Must include a narrative description of how the selected measure is nurse-sensitive in your organization and a narrative to describe the benchmark used

Graph 4: Inpatient Experience

Must represent one category from any inpatient unit

Graph 5: Ambulatory Patient Experience

Must represent one category from any ambulatory care setting

Unchanged Requirements

Nurse AVP/Nurse Director and Nurse Manager Education & Eligibility Table
OO11 Research Table
DDCT Report

Need Assistance?

If you have any questions about these updates, reach out to your Senior Magnet Program Analyst or contact the Client Advocate Team at Tipton Health. We’re here to guide you every step of the way throughout your Magnet^® designation and ongoing journey to nursing excellence!

Part Three: Connecting the Dots between Research, EBP, and QI

Welcome to the third and final part of our series on Research, Evidence-Based Practice (EBP), and Quality Improvement (QI) methods, this time with a focus on QI.

A QI project may be your best approach if your setting has already adopted recommended EBP but you want to ensure the EBP is utilized to the best of your ability. QI focuses on improving workflow processes by boosting operational efficiencies to improve organizational outcomes or reduce care process variations by increasing the reliable use of EBP to improve patient outcomes.

QI projects have evolved from continuous quality improvements and total quality management philosophies that focus on systems, processes, functions, or a combination. For example, your organization may deploy Lean and Six Sigma consultants or quality consultants that use small tests of change with a Plan-Do-Check-Act (P-D-C-A) cycle. Typically, QI projects will involve monitoring process measures, such as door-to-treatment times, first-case-on-time-start, or bundle compliance that ultimately affect a larger patient outcome, such as hospital-acquired infection (HAI) rates. A QI project may also focus on operational outcomes like cost savings. This makes QI projects great for EOs focused on reducing HAIs or with revenue-related outcomes. A QI project may also impact the work environment or workflow, making them great for the NK9EO examples. We have some helpful tips for beginning a QI project and additional examples where they can be a good fit.

Consider creating a simple QI activity template to capture the action steps, team member names, and dates. If your organization uses Key Driver Diagrams (KDDs), these make an excellent QI activity template.
An intent statement may not state a specific requirement for a QI activity; however, good fits include EP8EO, EP10, and EP11.
National, state, and regional quality collaboratives often use QI implementation science to implement EBP in participating settings. They then monitor process measures (compliance with infant back-to-sleep in hospitals) that impact patient outcomes (state infant mortality rate). When tapping into collaborative work for stories, be sure to highlight the appropriate methodology steps and link the actions to hospital or unit patient outcomes, rather than the process measures.

We have also compiled a table to help break down the characteristics of Research, EBP, and QI and tie them all together. Good luck choosing your examples and the best approach for each!

	QI	EBP	Research
Question	Are we optimally performing our current policy, practice, or procedure when we deliver care?	Does our current policy, practice, or standard operating procedure reflect the best available evidence? It is optimal quality compared to the evidence levels, and relevant for the patient?	Is one policy, practice, or procedure superior to another for achieving an outcome? What are factors and processes that lead to an outcome?
Goal	Improve the performance of a specific task or process following institutional policies or standards.	Find existing research that demonstrates the best policy, practice, or procedure to produce a specific patient outcome in a specific population.	Describe a phenomenon, develop or test a new method or hypothesis, or evaluate the implementation of a new method.
Method	Methodically identifies areas where performance falls short of the standards set by the organization. Use evidence from the literature to implement interventions aimed at improving performance to meet the set standard (e.g., staff education, workflow redesign, revised informatics, or communications), and then evaluate whether the intervention improved performance. Patient outcomes may be used as a proxy for or indicator of performance. Typically employ a pre-post design to compare outcomes before and after the best policy, practice, or procedure is implemented or optimized. Generally, QI will not include randomization or other means of assignment to a control group.	If the best practice differs from the organization’s current practice, the organization adopts the best practice and evaluates whether outcomes improve after the change. EBP typically employs a pre-post design to compare outcomes before and after the best policy, practice, or procedure is implemented or optimized. EBP generally will not include randomization or other means of assignment to a control group.	Research methods vary depending on the aims of the study and may include any systematic qualitative and/or qualitative investigation designed to contribute to generalizable knowledge. If there is genuine uncertainty about which policy, practice, or procedure is best, a research project is needed to generate this knowledge. Since the best policy, practice, or procedure is not yet known, it is ethical to assign some individuals to receive one and some to receive another through randomization or other means of assignment to a control group. In situations where one policy, practice, or procedure is known or suspected, based on evidence, to be superior to another, it is not ethical to assign some people to receive the superior and others to receive the inferior.
Intent	Improve the process of care delivery within the organization. The intent is not primarily for the dissemination of findings.	Implement a new practice standard within the organization. The intent is not primarily for the dissemination of findings.	Generate new knowledge and disseminate findings to the scientific community. A research study may also have direct benefits to patients in the organization, although not the primary purpose.
Scope	Optimization of care that is already the standard or has already been tested in other environments to demonstrate safety and efficacy.	Implementation of care that is already the standard or has already been tested in other environments to demonstrate safety and efficacy.	Implement and evaluate new, modified, or adapted practices that have not been adequately tested previously for safety and efficacy.
Participants and Setting	Undertaken by staff who normally are responsible for overseeing quality in the practice area.	Undertaken by staff who normally interact with the population included in the project.	Target populations outside the practice or oversight areas of the study team.
Data Collection and Storage	Must protect data confidentiality with team members 1) only access the minimum amount of data required to meet the objective; 2) establish and follow a plan for data storage and who can access it; 3) and destroy the data after the project and dissemination of findings is complete.	Must protect data confidentiality with team members 1) only access the minimum amount of data required to meet the objective; 2) establish and follow a plan for data storage and who can access it; 3) and destroy the data after the project and dissemination of findings is complete.	Must protect data confidentiality with team members 1) only access the minimum amount of data required to meet the objective; 2) establish and follow a plan for data storage and who can access it; 3) and destroy the data after the project and dissemination of findings is complete. May collect data through intervention (e.g., drawing labs) or interaction (e.g., conducting surveys or focus groups) with the population.
Benefit	Must have the potential for direct benefit to the population included in the project.	Must have the potential for direct benefit to the population included in the initiative.	May or may not have a potential for direct benefit to the study population.
Risk	Must not introduce risks greater than those associated with the organization’s current policy, practice, or procedure. Sometimes, it is best to build in balance measures to ensure there is no unintended harm related to the practice change.	Must not introduce risks greater than those associated with the organization’s current policy, practice, or procedure. Sometimes, it is best to build in balance measures to ensure there is no unintended harm related to the practice change.	May or may not introduce risks greater than those associated with the organization’s current policy, practice, or procedure. The IRB is responsible for evaluating the level of risk associated with research, ensuring that appropriate measures are in place to reduce risks, and determining whether the level of risk is acceptable in relation to the potential benefits.

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