Healthcare Designations of Excellence

Healthcare Designations of ExcellenceJoint Commission accreditation is a well-known symbol that a healthcare facility is providing quality care and upholding high standards of patient safety. When it comes to a focus on nursing, however, becoming designated through the Magnet Recognition Program® is the highest honor an organization’s nursing program can receive. Research shows that nurses working in Magnet hospitals have higher job satisfaction, due to increased autonomy and a sense of empowerment. Higher patient satisfaction scores and improved clinical outcomes are also correlated with Magnet status. Clearly, these enhanced metrics benefit all stakeholders. 

But achieving Magnet status requires a significant investment of both time and money. A 2014 report stated that

On average, the process of attaining Magnet status takes 4.25 years to complete with an average total investment of $2,125,000. Because of the serious investment and commitment of resources that are required, the decision to pursue Magnet designation calls for the full support of the organization’s leadership team and board of directors. Thus far, fewer than 400 hospitals in the U.S. have attained Magnet status.

Not every healthcare facility has the resources to devote to pursuing the Magnet journey. The American Nurse Credentialing Center (ANCC), which coordinates the Magnet program, recognizes this and has responded with an alternative. Through the Pathway to Excellence™ designation, hospitals can demonstrate a commitment to nursing excellence without straining their resources. For some of these hospitals, Pathway may be a first step to Magnet status—a method of making the journey more manageable. For others, it will be the final destination.

Pathway to Excellence is especially popular with rural hospitals, which is where the award started. It began in 2003 under the name Nurse-Friendly award, in rural Texas hospitals that took steps to create positive work environments for nurses. The ANCC took over managing the award program in 2007, and extended it to hospitals nationwide. Like Magnet, it requires meeting certain standards, applying for recognition, and then maintaining those standards through an ongoing process and commitment. The main difference is that nursing excellence is not verified through site visits and in-person appraisals, as it is with Magnet. Instead, appraisers review the application documents and then use a confidential survey of the nursing staff to verify that the hospital meets practice standards.

Now that Pathway to Excellence has removed its rural focus, the National Rural Hospital Association has filled that gap with the Rural Health Awards program. The awards are presented once a year to both individuals and organizations “who have dedicated their time and talents to improving the health and well-being of others.” According to the website, “Previous recipients have stretched the boundaries of possibility by forging innovative programs and services, making rural life healthier and more compassionate.” Nominations may include nurses, although there is no award specific to nursing excellence.

Yet another healthcare designation of excellence is the Malcolm Baldrige National Quality Award. This program was established in 1987 with a focus on service industries and small businesses; a healthcare award was added in 1999. While there were only two healthcare winners in 2014, any hospital can use the Baldrige Excellence Framework as the foundation for a general quality improvement initiative. According to a recent report, “Baldrige hospitals were recording faster five-year performance improvement than peers, and were 83% more likely to be among Truven Health Analytics’ 100 Top Hospitals®.” The Baldrige Criteria for Performance Excellence do not focus specifically on nursing excellence, but more generally on categories like patient safety, patient outcomes, clinical benchmarks, nursing staff engagement, overall staff satisfaction, and community service. But because the Framework and Criteria are flexible, any healthcare organization could apply these tools toward a creative and flexible plan to pursue nursing excellence.

If your hospital is currently on a quality improvement Magnet journey, you may soon find yourself on a journey of your own, as you work to meet new educational requirements. The IOM has called for hospitals to voluntarily increase the percentage of nurses that hold BSN degrees to 80 percent by the year 2020. As a result, hospitals are encouraging and even paying for nurses to go back to school. American Sentinel University is an innovative, accredited provider of online nursing degrees, including programs that prepare nurses for a specialty in case management, infection control, and executive leadership