Leading Change: A Case Study of the First Independent Critical-Access Hospital to Achieve Magnet® Designation

The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®. Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources. Staff...

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Bibliographic Details
Published in:The Journal of nursing administration 2018-03, Vol.48 (3), p.141-148
Main Authors: Nelson-Brantley, Heather V, Ford, Debra J, Miller, Karen L, Stegenga, Kristin A, Lee, Robert H, Bott, Marjorie J
Format: Article
Language:English
Subjects:
Attitude of Health Personnel
Case reports
Clinical governance
Evidence-based nursing
Excellence
Hospitals
Hospitals, Rural - manpower
Hospitals, Rural - organization & administration
Hospitals, Rural - standards
Humans
Interprofessional Relations
Leadership
Nurse Administrators - organization & administration
Nurse Administrators - standards
Nurses
Nursing
Nursing administration
Nursing Staff, Hospital - organization & administration
Nursing Staff, Hospital - standards
Organizational Case Studies
Organizational Culture
Organizational Innovation
Professional development
Quality of care
Total quality
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Summary:The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®. Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources. Staff nurses, nurse managers, interprofessional care providers, the chief nursing officer, and board of directors (n = 27) were interviewed. Observations of hospital units and administrative meetings were done, and hospital reports were analyzed. Nine themes emerged to support a conceptual model of leading change. The CAH spent 3 years of its 6-year journey establishing organizational readiness. Nurses overcame complex challenges by balancing operational support and fostering relationships. The Magnet journey led to significantly improved nurse and patient outcomes. A new organizational culture centered on shared governance, evidence-based practice, and higher education emerged. The journey to Magnet leads to improved nurse, patient, and organization outcomes.
ISSN:0002-0443
1539-0721
DOI:10.1097/NNA.0000000000000588