Nursing staff pursues elite quality status

If all goes to plan, Washoe Health Center two or three years from now will host a ceremony at which it will be designated as a Magnet hospital by the American Nursing Credentialing Center.

It will be a big deal.

Barely more than 100 hospitals in the United States, after all, have won the designation.

But Ron Laxton, chief nursing officer for Washoe Medical Center's four-hospital system, says the ceremony and the designation itself aren't nearly as important as the statement that the medical center and its staff made in their decision to pursue Magnet status.

In fact, a group of Washoe Medical employees on their own began work on the program before Laxton arrived at the hospital about 16 months ago.

"I just joined the journey," he says.

"This is staff-driven."

The designation program operated by a subsidiary of the American Nurses Association reflects the belief that the quality of nursing care is among the best ways to judge whether a hospital does a good job.

The 14-point program peers deeply into all the nursing operations of a hospital that applies for Magnet status.

Among the many questions:

* Does the hospital provide good opportunities for the professional development of the nursing staff?

* How many hours of nursing care do patients receive each day?

* Does the hospital's culture encourage nurses to use their professional skills appropriately?

* Does the chief nursing officer have a master's degree?

* Is the nursing staff managed with a flat organizational structure, or do layers of bureaucracy separate nurses from top managers?

"It's a very rigorous review," Laxton says.

"It's all about supporting nurses in autonomous nursing practice."

Perhaps the most important piece of the review, Laxton says, is the participation of Washoe Medical Center in a study comparing its clinical results against those of 400 other hospitals.

"By benchmarking ourselves against the best hospitals in the world, we are able to provide a better quality of care for our community," he says.

Washoe Medical Center is just beginning the compile the documentation it needs to support its application five notebooks, each 3 inches thick.

Then comes a visit by certification team and a decision on whether Washoe Medical will win the designation.

More than a third of applicants for Magnet status fail to make the cut, Laxton says.

While the drive to win the Magnet designation began with the medical center's staff, Laxton says it's had strong support from board members and top executives some of whom sat through day-long orientation sessions about the program.

And the organization will invest more than $30,000 in application fees in the process.

The payoff, Laxton says, won't be easily measured in financial terms.

As Washoe Medical seeks Magnet designation, he says, it makes a clear statement within the organization about the standards it expects to meet.

That, in turn, will help the organization attract more quality-oriented professionals nurses as well as others.

"We'll be spending less money on billboards and TV to recruit nurses," Laxton says.

Washoe Medical Center won't be starting from scratch in its effort to meet the certification standards.

"We have many of the components in place," Laxton says.

"We're tying it together."