Kaiser Permanente: Magnet Excellence Journey

EXECUTIVE SUMMARY

KAISER PERMANENTE: MAGNET EXCELLENCE JOURNEY

AIM

Building a Culture of Excellence

Lead the nation in: 1) Advancing affordability, 2) Transforming care experience & delivery, and 3) Improving population health through an empowered, engaged workforce.

PROBLEM/OPPORTUNITY

American Nurses Credentialing Center (ANCC) Magnet designation represents the “gold seal” for global nursing excellence; only 7% of the nation’s hospitals have obtained Magnet recognition. In March 2017, Irvine Medical Center was the first within the Kaiser Permanente system to achieve Magnet status. Irvine’s achievement raises the professional practice/quality bar and has heightened interest and inspiration from others within the KP system to leverage the Magnet excellence roadmap.

SOLUTION/FRAMEWORK

Invest in a proven, outcomes-driven, healthcare “excellence” framework that supports patients’ expectations of tomorrow. The mechanism to begin the journey to excellence starts with the roll out of the Voice of Nursing 1.0 (3-Day Workshop) and Voice of Nursing 2.0 (Site Visit). The Voice of Nursing 3.0 (Magnet Excellence Components) provides a framework for nursing practice and research, as well as serving as a roadmap in shaping changes essential to the continued development of the nursing profession and to quality outcomes and patient care. Magnet’s seal of excellence has a strong value proposition for the organization, consumers, and for the recruitment & retention of high performers. ANCC’s Magnet Recognition Program provides sustainable, culturally transforming processes and systems focused on the following components: 1) Transformational Leadership, 2) Structural Empowerment/Engagement, 3) Exemplary Professional Practice/Interprofessional Collaboration, 4) New Knowledge, Innovation, & Improvement, and 5) Empirical Quality Outcomes.

COMPETITION

Consumers’ awareness is increasing in regards to Magnet recognition and the association with superior nursing care and outcomes. RN graduates increasingly are associating Magnet designated hospitals with heightened professionalism, healthier work environments, and employers of choice. Nursing constitutes one-third of KPs’ workforce. If Kaiser is truly on par with Magnet hospitals, then shouldn’t all our Kaiser Permanente RNs be recognized as such and the public made aware of Kaiser Permanente Nursing excellence. We currently have gaps within the Magnet excellence criteria…imagine where we could be comparatively within this healthcare environment if we closed those gaps system-wide.

Competitive Risks/Reputational Risks

• National Recognition of Magnet: US News & World Report utilizes Magnet designation as a primary competence indicator; 2015: 14 of the top 15 on the US News Best Hospitals in America Honor Roll are ANCC Magnet organizations.

• Magnet Hospitals growing at 32% per year

• Competitive threat: Attraction of New Grads to Magnet Facilities

• 28 California hospitals are Magnet designated; KP Irvine Medical Center is the most recent (March 2017)

• Centers for Medicare & Medicaid Services (CMS) Value Based Purchasing incentive payments on measures of care experience & quality – drives competitors to work leaner and smarter

FINANCIALS/BENEFITS

While it is unclear at this time what the definitive financial implications are for Kaiser Permanente, one can expect that our findings would be similar to those found in 2014 study findings which indicate that Magnet hospitals experience positive and significant increases in both inpatient costs and net inpatient revenue in comparison with non-Magnet hospitals. The findings indicate that on average Magnet hospitals are likely to receive $127.05 more per discharge than non-Magnet hospitals; or an estimated average annual gain of $1.2 Million.1

Current literature supports that a hospital’s Magnet Status is linked to Hospital Consumer Assessment of Healthcare (HCAHPS) scores. Magnet hospitals received significantly higher scores than non-Magnet hospitals in all “nursing care related” HCAHPS measures (with the exception of “responsiveness of care which was higher but not significant).2

Overwhelming, the literature supports an overall financial return related to Magnet designation including: improved retention, decreased turnover, improved satisfaction, improved quality and safety, increased customer attraction for hospital selection, and superior business results related to investment in professional nursing practice.3 Other Magnet designation positive financial impacts include increased press and media coverage, attraction and retention of top talent, enhanced partnering success, increased endowments, stronger bond ratings, and gained and maintained competitive advantage in regional markets (ANCC, 2016).

References:

Jayawardhana, J, et al; Is there a business case for Magnet Hospitals? Estimates of the cost and revenue implications of becoming a magnet; 2014; Med Care; 52; 400-406.
Chen, J. et al. Is the hospital’s magnet status linked to HCAHPS scores? J Nurs Care Qual; 2014, Vol 29, No 4. Pp. 327-335.
Dall, T.M., Chen, Y.J., Sifert, R.F., Maddox, P.J. & Hogan, P. F. (2009). The economic value of nursing. Medical Care, 47(1), 97-104.