Case Presentation
A form of HCO that offers nurses the opportunity to fullyrealize their professional role is the Magnet© organization. Magnetorganizations are HCOs, primarily hospitals, that have adoptedorganizational practices that promote excellence in nursingpractice. The HCO that adopts Magnet principles is committing to anorganizational design and structure that empowers nursing staff toachieve higher levels of performance through engagement andparticipation. The Magnet designation is only obtained after aprocess of learning and self-evaluation followed by changes to theorganization’s structure. These design changes provide adecentralized authority structure created to support participativemanagement and professional autonomy for nurses. Nurses working inMagnet facilities are expected to be active participants inorganizational processes, to govern themselves, to collaborate withother professional colleagues and to be both responsible andaccountable for the outcomes of nursing care.
Magnet designation is an empowerment model that captures themain features of the complex adaptive system. Adopting Magnetprinciples meant to attract and retain excellent nurses is,fundamentally, recognition that professional nursing is a valuableand scarce resource essential to the effective function of the HCO.Nurses are not simply workers in the system but are instead acritical component of the organization, making substantialcontributions to the success of the HCO. To achieve thisrecognition, an HCO must be able to demonstrate the fullintegration of professional nursing into its operations throughauthority structures that move decision making, power, and controlof practice to nurses throughout the organization. This is usuallyaccomplished through the creation of governance councils in whichall nursing staff are able to voice their concerns with care issuesand then make decisions that will affect how care is delivered inthat facility. Professional decision making is no longer theexclusive domain of the nursing executive and directors. Instead,there is a flattening of hierarchical relationships related toauthority and control over practice with more of theresponsibilities for care outcomes being assumed by nursingstaff.
1. Would a reference to nursing logically fit in the missionstatement of a magnet?
2.What are examples of how a magnet HCO captures the mainfeatures of a complex adaptive system?
The HCO must also demonstrate that appropriate processes are inplace that allow for the development of innovative care strategiesand that nurses can implement and review the results of theirinnovation efforts. Quality management in Magnet organizations isrobust, and nurses are fully involved in creative activities thatencourage continuous quality improvement and the achievement ofexcellence in nursing care. These facilities promote the continuingprofessional development of their nurses by supporting educationand career-ladder programs.
Case Analysis
This care exemplifies the concept Health Care Organizationsmajor and minor attributes of purpose, public trust, structure, andorganizational environment. Although Magnet designation is specificto nursing, the adoption of a Magnet design by an HCO has spilloverbenefits for the entire organization. Because the HCO is anintegrated system and professional nursing is the largest workforcein most of these organizations, an active and engaged nursingworkforce positively influences other members and other componentsof the HCO. Empowered nurses act as transformative agents in theMagnet structure, leading efforts to improve the quality of careand inspiring others in the organization to join in the effort tocreate better systems and improved HCO outcomes. In the end, theHCO with Magnet designation benefits from increased collaboration,self-determination, and participation by nurses because thisincreases the capacity of the organization to adapt to uncertaintyand change.
