HomeMagnet® and Pathway to Excellence®Pivotal role of the Magnet® program director

Pivotal role of the Magnet® program director

Author(s): Sarah Ann Mowry Lackey, DNP, RN, CCNS; Tanya F. Lott, DNP, RN-BC; and Jill Whade, MSN, RN, CPN

Fanning the flames of nursing excellence.

Celebrating Magnet® designation is a day like no other. Whether it’s the first, third, or fifth designation, this achievement—which represents quality, excellence, innovation, and leadership—is something to be celebrated.      

American Nurses Credentialing Center (ANCC) Magnet designation has become one of the blueprints health­­care organizations use to attain and sustain nursing excellence. Applying Magnet standards to engineer nursing culture results in progressive structural, process, and outcome improvements that directly and indirectly affect patient care and organizational metrics. Since its inception in the 1990s, Magnet designation has moved nursing forward, demonstrating its impact in all areas of healthcare. Studies have shown better patient outcomes, including reduced mortality rates, and significant improvements in the work environment in hospitals that have received the designation compared to those that haven’t. Benefits also include pride in nursing practice, which leads to recruitment advantages for Magnet hospitals. 

Magnet designation is the result of intentional work by leaders, clinical nurses, interprofessional colleagues, teams, and workgroups across the organization. At the center of all that work is a key player—the Magnet program director (MPD). 

Magnet - Nursing ExcellenceANCC requires organizations to identify a designated MPD. Along with the organization’s chief nursing officer (CNO), the MPD is the primary contact for communication with the ANCC throughout the designation cycle. The MPD plays a pivotal organizational role, serving as a critical facilitator in attaining and maintaining Magnet designation. The role is complex, diverse, and challenging. MPDs serve as data analysts and interpreters, authors and editors, and directors. (See Program vs. project director.

Program vs. project director

When the Magnet® director role was first created, it sometimes was called a “project director.” However, the distinction between the Magnet Recognition Program® as a project vs. a program is significant. A project is single-focused and frequently concludes quickly, whereas a program consists of a collection of ongoing projects that benefit the organization over time.

Magnet standards, if used strategically, provide a framework that organizations can use to continually guide nursing practice, aligning structures and processes to achieve excellent patient outcomes and improve the work environment. As hospitals move through designation and redesignation cycles, the process becomes continuous. Magnet, as a program of nursing excellence, is not merely a project to be focused on at the time of redesignation. It requires ongoing vigilance and oversight.

Data analyst and interpreter  

As healthcare data have become more abundant and amassed from numerous sources (including clinical records, financial records, wearable devices, medical devices, and research) across diverse disciplines, determining how to most effectively analyze and use the information to improve patient outcomes and stimulate innovation has been challenging. Analyzing and interpreting nurse-sensitive data are important to the MPD role.  

Many of the sources of evidence requested in the Magnet application manual are data centric. A challenging aspect of the MPD role is to facilitate the pursuit of empirical outcome measures, as opposed to process measures. Process measures capture quality improvement efforts, whereas empirical outcome measures reflect the impact an intervention has on patients’ health status. As individuals and teams construct quality improvement projects, the MPD must ask the question, “So what? How does this intervention impact the patient or the work environment?” Keeping an eye on quality initiative designs to ensure empirical outcomes are mea­sured is an aspect of the MPD role frequently overlooked but is vital to successful Magnet designation. 

The MPD uses data to objectively tell the story of nursing excellence and provide context for comparisons against national benchmarks. The National Database for Nurse Sensitive Indicators is one platform that provides nationally benchmarked nurse-sensitive indicators (such as falls, pressure injuries, and infection rates) required for Magnet evidence.  

In addition to data-centric examples, designating organizations also must present eight quarters of data for nurse-sensitive indicators (such as pressure injuries, catheter-acquired urinary tract infections, and falls with injury); the data must be compared to other organizations in a national database. To pass Magnet standards, more the half the units presented must be above average (for inpatient and outpatient care areas) in at least five quarters. Organizations also must exceed national averages in nurse satisfaction in the majority of units to move forward to the site visit step in the Magnet designation or redesignation process. 

MPDs have an opportunity and an obligation to ensure that nursing initiatives focus on empirical outcomes and that data are tracked, evaluated, and disseminated. MPDs help anchor nursing practice to outcomes by ensuring data are accurate, accessible, and understood by nurses at all levels.   

Author and editor 

In addition to data analysis and interpretation, MPDs oversee construction of one of the most comprehensive and sophisticated representations of Magnet excellence: the Magnet document. Magnet standards are exacting, so MPDs work to ensure the document is a precise and logical progression of ideas and facts that address each of the standards. Any ambiguity will result in an example being returned with requests for additional information. (See Narrative and empirical examples.)

Narrative and empirical examples

The Magnet® document requires two types of written examples to demonstrate achieved standards: narrative and empirical outcome examples.

Narrative examples are written to specific requested elements, and evidence validates each of the key points addressed in the example statement. Evidence for narrative items includes dated written documents, protocols, policies, and presentations.

Empirical outcome examples are written to specific requests for improvement, with graphic representation of pre-intervention and sustained improved post-intervention data used as evidence.

Requirements for each of these examples, which are precise and outlined in the Magnet Application Manual, represent a rigorous scholarly template for reporting nursing initiatives.

The designation cycle spans 4 years, and most MPDs will agree that producing a quality document takes 2 to 3 of those years. This work becomes an organization-wide activity as teams search for examples that accurately and clearly meet each standard, authors construct narratives according to required phrasing, editors revise for accuracy and syntax, readers review individual items to ensure requirements are met, leaders clear barriers to acquiring information and evidence, and units celebrate when their work is included. The MPD oversees and synthesizes the entire process, from the interpretation of each example statement to team education and uploading of the document into the ANCC electronic platform. 

Director 

While other nursing leaders are focused on day-to-day operational issues, MPDs focus on the strategic direction nursing must take to continually improve care delivery. They strive to align the organization with current Magnet standards, and they work with interprofessional colleagues across the organization to help guide its strategic direction. For example, MPDs collaborate with CNOs to identify gaps in nursing practice and develop improvement plans. This gap analysis is essential for sustaining the Magnet culture.   

Strong time management and organizational skills are needed to manage a Magnet program. MPDs also must possess excellent verbal and written communication skills. They’re called upon to provide education, present the impact Magnet status has on the organization, and work with internal teams, external consultants, the ANCC Magnet Program staff, and appraisers to ensure continual improvement. In addition, MPDs develop teams and individuals, grow programs, innovate, and help craft a culture that yields the type of examples of excellence that are presented in the Magnet document.  

Shared and professional governance councils are the main venues for involving clinical nurses and other frontline interprofessional staff in the development and implementation of the organization’s strategic plan. MPDs frequently lead these councils and serve as encouragers, mentors, and coaches.   

The constant state of change in healthcare can be distracting, but MPDs help ensure the focus of nursing stays on the Magnet standards, which translates into high-quality outcomes and engaged nurses. 

MPD role preparation  

MPD roles vary based on the size of the organization and available resources. Preparing for the role can be challenging, and the skill set is broad. Key skills include leadership, communication, program management, data analysis, scholarly writing, and education.  

Some MPDs have reported learning the role by trial and error, whereas others benefited from apprenticeship-like structures and mentoring provided by experienced MPDs. Mentoring and group support can help soften the learning curve and give new MPDs ready resources for questions and consultation. Some states (such as Maryland, North Carolina, South Carolina, California, and Virginia) organize groups of MPDs who meet regularly and provide support for each other. Lackey and colleagues recommend doctor of nursing practice education as preparation for the role.  

MPDs function autonomously, frequently without line authority, but they must influence organization-wide collaboration and cooperation to pull all the elements of the designation together, particularly in the construction of the Magnet document. Organizations that provide adequate training and mentoring opportunities for new MPDs can help ensure that their Magnet program is seamlessly managed and that the focus on improving nursing practice according to excellence standards is continually maintained. (To learn more about MPD orientation, read this article.) 

Moving practice forward 

The MPD role is challenging and rewarding. The broad skill set and the opportunity to influence nursing culture and work with colleagues at many levels in the organization are all advantages not found in many other roles. Mastering the MPD role is a professional accomplishment unlike many others. Developing the required skills can help MPDs excel in just about any other role they pursue. Many nurses in the MPD role are tapped to undertake sophisticated, innovative, and change-oriented initiatives.  

Magnet designation is the engine that has moved nursing practice forward, within organizations and within the profession. At the heart of the effort in each organization that’s achieved the designation is the MPD.

Sarah Ann Mowry Lackey is system-wide manager of nursing excellence and retention at Cone Health in Greensboro, North Carolina. Tanya F. Lott is system-wide director of nursing excellence for Roper St. Francis Healthcare in Charleston, South Carolina. Jill Whade is Magnet program manager at WakeMed Health and Hospitals in Raleigh, North Carolina. 

References 

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