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Nursing Excellence Makes a Difference to Patients

Rebecca Hendren, for HealthLeaders Media, January 26, 2010

Last year I moved from Boston to a suburb just north of Charlotte, NC, and I recently needed to make a decision about which hospital I should visit. In Boston, I had been spoiled for choice, with a multitude of famous, big-name hospitals to choose from. Being new to North Carolina, I was faced with a more difficult choice as I knew nothing about the two big players in town.

I did some research and both places appeared to be outstanding. What made me choose one over the other? It was designated as an ANCC Magnet Recognition Program® facility. If I'm going to be hospitalized, I would rather be in a designated center for nursing excellence. Studies have shown that Magnet Recognition Program (MRP) organizations have better patient outcomes, higher nurse to patient ratios, lower nurse turnover, higher rates of nurses with advanced degrees or professional certifications, and happier nurses, which generally translates to happier and more satisfied patients.

Happier nurses improve satisfaction results, which must be regularly measured and benchmarked at MRP hospitals.

I wanted to know what makes nurses more satisfied at MRP-designated facilities, so I spoke with senior nursing leaders at Massachusetts General Hospital, my old stomping grounds. MRP-designated Mass Gen has also been rated highly in US News & World Report's annual list of America's Best Hospitals. It ranked No. 12 on the list for best nursing care (highest percentage of patients who said their nurses were "always" courteous, listened carefully, and gave clear explanations) and No. 7 for patient satisfaction.

Mass Gen's Chief Nurse and Senior VP for Patient Care, Jeanette Ives Erickson, says the culture of the organization creates an excellent nursing environment and high rates of satisfaction. At Mass Gen, the nursing culture has a unity of purpose, she says.

"What unifies us as a nursing service is the passion for our patients. We are very much a patient- and family-centered organization, and I think that's what helps to establish our unity of purpose," says Erickson.

Erickson notes nurses at the hospital are highly educated and that research and education are valued. Of the almost 4,000 RNs, 75.3% have at least a BSN, 7.2% have an advanced degree, and there are 55 doctoral-prepared nurses.

The organization also empowers its nurses to make decisions. "We have had a collaborative shared governance structure in place since 1997. So we have people who give the care at the table contributing to decision making about how we will take care of patients," says Keith Perleberg, director of nursing quality.

Susan Morash, nursing director, adds that accountability and authority rest with clinicians. "It's a big satisfier for them to know that bedside decision-making is supported and recognized," she says, citing the nursing practice committee, where nurses can decide together whether to make changes to their practice.

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