Thank you for reading the Summer/Fall 2021 edition of the Magnet® Newsletter from Tipton Health. This edition features an interview with Mary Del Guidice — Tipton Health’s first-ever Chief Nursing Officer, recommendations on how to prepare for your next Magnet® designation, and other tips and insight from the experts at Tipton Health.
- Introducing Mary Del Guidice: Tipton Health’s First Chief Nursing Officer
- Nurses Can Help Secure Health Equity
- PHI—And How to Avoid It
- Dates: An Essential Component of Your Magnet Documents
- Writing an Effective EO Goal Statement
- Prepare Now for Your Next Designation
- Help Us Plan Our Fall Nursing Leadership Webinar Series
Introducing Mary Del Guidice: Tipton Health’s First Chief Nursing Officer
Mary Del Guidice, MSN, BN, RN, CENP, was named Tipton Health’s first-ever Chief Nursing Officer in July. Mary will be responsible for nursing client relations and nursing excellence consulting. She answers a few questions for the newsletter about what she will bring to Tipton Health’s clients.
Why did you become a nurse?
I can recall at a very young age being in an emergency room, looking up at the nurses and thinking I wanted to be just like them. They made me feel better and I thought what they did for me was magical. I wanted to make people feel the way they made me feel. From that moment, I felt a strong calling to be a nurse and never considered anything else. I have been a nurse for 38 years and have loved every moment, and I feel very fortunate to do something I love every day.
What made you decide to pursue nurse leadership positions?
I began my career as a clinical nurse on the night shift, loved every minute and never envisioned anything else.
My leadership career was inspired by many people. I was starstruck when I met my first CNO, Toni Fiore. She had this way about her that made everyone she interacted with feel special. I knew I wanted to be “like her.” Not necessarily a CNO, but someone who could also make other nurses feel special.
Eventually, a nurse manager position opened, and some colleagues were talking negatively about the staff, stating that they were a bunch of “brats,” they had been through many managers in a short period of time, and no one wanted to be their manager. This upset me because I knew the nurses and believed they just needed someone to care about them. This—along with a nudge from my mother, who advised me that I would impact more patients in a leadership role, and the confidence and support of my CNO—made me decide to become a nurse manager. I fell in love with my team and, to this day, have a picture of them in my office and stay in touch with some of them.
What are some accomplishments that make you proud?
As I think of accomplishments what always comes to mind are the many extraordinary people connected to each one. First and foremost, I am most proud of the teams I have been honored to work with and all that we became, built and accomplished together.
I remain tremendously proud of the team I had the honor of working with as a nurse manager. We began together with the lowest outcomes in the organization. We imagined together that we were opening a new hospital and recreated every aspect of care and operations on our unit. We even had a grand opening to celebrate “our new unit”! Our mantra was “happy staff makes happy patients”! We started with such low outcomes that we just decided to focus on doing the right things and knew the numbers would follow. Just two years later at the annual hospital patient satisfaction awards, I remember sitting thinking, here we go—the same unit is going to win again. I was shocked when they announced our unit. We had achieved six quarters of consistent improvement and had the highest scores in the organization. This led to our team winning the Press Ganey Client Success Story Contest. Our success continued as we also achieved the highest scores for RN satisfaction. It was a very special team—they were all heart—and I remain very proud of all that we became together.
Also, I’m always very proud to share that I was part of the first nursing team outside of the pilot to achieve Magnet® designation. This means that we were the first to go through the Magnet application process. At the time, I was a nurse manager and was asked by the CNO to lead the site visit preparations. While I didn’t really know what that meant, I did know it would require the help of nurses from every unit and every shift. This was the beginning of what became the “Magnet Champions” program.
After we achieved Magnet designation, countless organizations visited our organization to learn how we did it and how to create a “Magnet Champions” program. I also presented the concept of Magnet Champions at the second and third Magnet Conference. More than 25 years later I smile every time I hear someone refer to their “Magnet Champions.”
What are some of the most significant challenges facing nursing leaders today? What do you hope to achieve as Tipton Health’s first Chief Nursing Officer?
The most significant challenges I hear from nurse leaders today begin at the bedside and extend to the boardroom. Frontline nurses and leaders are exhausted, and RN turnover is increasing nationally. In addition, the financial state of healthcare is very fragile, causing nurse leaders to continuously define the value of nursing and advocate for scarce resources more vigorously than ever before.
The overarching challenge for nurse leaders is to balance addressing the urgencies of this time while remaining steadfast to the transformational leadership practices that secure a positive work environment, enabling an enriched and engaged workforce and the highest-quality care.
I am very proud to now be part of a team that is supporting and partnering with nurse leaders to successfully navigate these challenges.
Before becoming the Tipton Health CNO, I had the opportunity to work with the Tipton team as a consultant. In my first meeting CEO Dan Tipton, he spoke of the way the team truly cared about Tipton Health’s clients and their success. He made it very clear to me that the team wanted to have real impact at the bedside. Dan also shared his great appreciation for the profession of nursing and the work of nurse leaders.
From the start, I observed and admired the unrelenting dedication and authentic concern the entire Tipton team shared with their clients. This has been especially evident throughout the pandemic as the Tipton team quickly pivoted to address nurse leader needs, offering services such as free webinars that provided support through relevant topics such as team well-being. This dedication to making a difference is just one of the many reasons I feel very fortunate to join the Tipton team.
As CNO, I look forward to building upon the legacy of caring, success and partnerships that Tipton Health has created. Our goal is to be the team that all healthcare leaders turn to and rely on as they address the challenges of the day while also forging ahead to achieve their vision, from the bedside to the boardroom.
Today we are helping teams with everything from achieving Magnet and Pathway designation to improving the work environment for nurse leaders and staff, from developing strategic plans to redesigning care models, from strengthening shared decision-making to coaching nurse leaders, and everything in between.
Finally, on a personal level, I look forward to continuing my calling as a nurse by working with the entire Tipton Health interprofessional team to support nurse leaders and their teams as they realize their visions, hopes and dreams.
Nurses Can Help Secure Health Equity
The coming years will present new and complex challenges for the nation’s nearly 4 million nurses, who represent the largest of the healthcare professions. Working at the intersection of health, education and communities, nurses are often the first and most frequent line of contact with people of all backgrounds seeking care.
In May 2021, the National Academy of Medicine (NAM) released a report titled The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. An expert committee completed the report to “extend the vision for the nursing profession into 2030 and chart a path for the nursing profession to help our nation create a culture of health, reduce health disparities, and improve the health and well-being of the U.S. population in the 21st century.”
The report explores how nurses play a critical role in reducing health disparities and promoting equity, while keeping costs at bay, using technology, and maintaining patient- and family-focused care into 2030.
Originally scheduled for release in December 2020, the report was delayed until May to include lessons learned from COVID-19 and our nation’s racial and social justice issues, according to Susan Hassmiller, PhD, RN, FAAN.
Dr. Hassmiller, senior adviser for nursing at the Robert Wood Johnson Foundation and senior scholar-in-residence for the National Academy of Medicine, gave a presentation on the report in a June 2 webinar hosted by Columbia University School of Nursing and attended by nursing leaders and experts.
Regina Cunningham, PhD, RN, NEA-BC, FAAN, CEO of the Hospital of the University of Pennsylvania, served on the committee that helped draft the Future of Nursing report. She said low-income and minority communities were particularly hard hit by the pandemic.
“COVID-19 didn’t cause these things, but it showed us where a lot of the health disparities exist,” Dr. Cunningham said.
The NAM is also presenting a four-part webinar series exploring the blueprint for the next decade of nursing. The series covers addressing social determinants of health and achieving health equity, lifting barriers to expand nurses’ scope of practice, addressing nurses’ well-being, and diversifying the nursing workforce to advance health equity.
PHI—And How to Avoid It
Among the many issues connected to writing Magnet narratives, one of the knottiest is protected health information—PHI.
PHI is any personal information that enables your readers to identify a specific person mentioned in the story.* We are required, under the HIPAA Security Rule, to ensure that cannot happen. The challenge, of course, is to navigate our way through a story by sharing enough information without breeching confidentiality. For this discussion, we’re focusing on the non-EO narratives in which you’re asked to write a patient-specific story: SE11, EP3, EP5, EP12, EP13, EP14 and EP17.
Names? Addresses? Dates? Bah! you say—I’m hardly likely to divulge any of that information in a Magnet example. But the fact is, your Tipton editors have seen a few of these nuggets slip by. They’re often embedded on page 12 of the patient record—things like the brother-in-law’s name and cell number. That, my friends, is PHI.
So, apart from scrupulously reading every single word of your supporting evidence, how else can you protect your Magnet application?
- Be generic in the patient-specific narratives. Don’t even use the patient’s initials: Stick with “John Doe” or “Jane Doe.” You know to redact everything in evidence related to the patient. We also encourage you to redact room numbers and names of personal physicians or practices.
- Do not include narrative references to where the patient lives/works or the names of short- or long-term facilities where the patient visits or lives. In evidence, redact those pieces of information.
- Do not write specific dates (in patient-specific narratives only). Write “In 2020, …” Redact both the month and the date in supporting evidence.
- Do not include any personal information about the patient (e.g., previous medical history, family relationships or marital status) that doesn’t help the story meet intent.
On a related topic, note that not all redaction strategies “work.” There have been many instances in which a client has blacked out text with a Magic Marker, but Tipton editors can still see the text, especially on a large monitor. We strongly recommend using software designed to redact your text.
If you would you like more tips on how to write your Magnet application, email Dan Tipton at email@example.com, and he’ll tell you how we can help you tell your story.
Dates: An Essential Component of Your Magnet Documents
Some of the most essential pieces of information in your Magnet document are the dates related to your narrative or outcome graph. Your appraiser uses these dates to ensure that the story fits within your Magnet window—and if it doesn’t, they’ll ask you for additional documentation.
Dates also help the appraiser establish your pre-intervention, intervention and post-intervention timeframes in the graphs in your EO documents. As you’re collecting stories and data for your Magnet documents, remember to include the date for each intervention and key event in your narrative.
Need help with dates or any other aspect of writing your Magnet documents? Email Dan Tipton at firstname.lastname@example.org.
Writing an Effective EO Goal Statement
The Goal Statement is a very short yet critical section in an EO. It has only two elements:
- The Goal: The desired result of the PI project.
- The Measure of Effectiveness: Identifies the outcome metric that quantifies the degree of improvement. We must attach a graph of the Measure of Effectiveness in the Outcomes section of the EO—and the data must demonstrate a “sustained improvement.”
A couple of things to keep in mind when writing your Goal and selecting your Measure of Effectiveness: Magnet requires that you have a Goal, and that you meet or exceed your Goal. Period. Those two things are non-negotiable. Beyond that—you decide how tight of a box you want to live in. Magnet does not require you to compare your performance against a benchmark for “regular” EOs.
We do have to compare our performance against national benchmarks in the Fab 5 documents. But that’s another story—for “regular” EOs you don’t have to. So, why would you? You decide on the level of specificity of your goal. I recommend you write broad goals using words like “to reduce” or “to increase.” That way, any movement in the right direction with your data means you’ve met Magnet’s requirement of “meeting or exceeding” the goal.
- Goal: To reduce the patient falls with injury rate on 3 South
- Measure of Effectiveness: 3 South’s Patient Falls with Injury Rate
When it’s done right, the Goal Statement is a very simple section in an EO. But when it’s not well thought out, it can become a nightmare! Be careful when you write your Goal Statement.
This was an excerpt from Tipton Health’s Magnet Writers Workshop. To learn more about the workshop, please contact email@example.com.
Prepare Now for Your Next Designation
|Where are you on your Magnet Journey?||Task||Need help?
We’re at your service!
|3 to 5 years before your submission||Develop or revise your nursing strategic plan.||Tipton Health’s executive nursing consultants will help you prioritize your work and align your strategic plan with your Professional Practice Model and the Magnet framework.|
|Verify with the ANCC that your nursing satisfaction survey instrument and patient satisfaction survey instruments (inpatient and ambulatory) meet Magnet requirements.||Tipton Health’s data team can help you make sense of your data and ensure you are collecting the right data to meet Magnet requirements.|
|18 months to 3 years before your next submission||Complete a Magnet Readiness Assessment.||You can do a self-assessment or have Tipton Health come on site to help you identify any lingering gaps. (Are you an initial designation or facing more significant challenges? You might be eligible for Tipton Health’s new Nursing Excellence Assessment Tool.)|
|About 18 months before your submission||Collect your narratives, evidence and outcome data.||Consider Tipton Health’s Magnet Deep Dive workshop.|
|Educate your Magnet writing team.||Consider Tipton Health’s Magnet Writers Workshop.|
Contact us at firstname.lastname@example.org for more information.
Help Us Plan Our Fall Nursing Leadership Webinar Series
We’re planning our Nursing Leadership Webinar Series for this fall, and we’re putting together content that is sure to hold your interest. Our topics include a detailed review of the 2023 Magnet manual; how to recruit and retain nurse leaders and much more; and lessons learned from the continuing battle against COVID. But we’d like your help. How can we make this series as helpful to you as possible? Tell us what we can do to improve the webinars and give us your topic ideas by clicking on the following survey link.