By Joelle Moran
A commitment to a culture of caring and longevity of staff have contributed to the success of Craig Hospital, which last week received its second consecutive Magnet recognition for nursing excellence.
Craig is one of only two freestanding rehabilitation hospitals in the world to earn the Magnet designation.
The Denver hospital’s unique mission of specializing exclusively in spinal cord injury and traumatic brain injury allows the staff to stay clearly focused on its mission, said Diane Reinhard, chief nursing officer and vice president of patient care services.
Reinhard said she’s often asked how the staff can work at Craig for so long, caring for newly disabled patients who may not be on their best behavior, which can be difficult.
"It’s their professionalism that they have and a commitment to care," Reinhard said of her nursing staff. "The culture of caring is so important and very unique due to the longevity of our staff and the focus of our mission."
The average length of service at Craig is 20 years for physicians and department directors, 13.5 years for therapy staff and eight years for nurses.
Having highly satisfied and engaged nurses equates to a higher level of patient care and positive outcomes, Reinhard said, which are two pillars of the Magnet recognition.
"(Magnet) says that our staff works in an environment that they rate as good, which ultimately results in patients getting their needs met and a higher quality of patient care," she said. "The patient does win. The nurses are compassionate and committed to their employer and provide better care."
The Magnet Recognition Program, created in 1990 recognizes health care organizations that provide the highest-quality nursing care and uphold the traditions of professional nursing practice. In 2005, Craig was the third hospital in Colorado to receive this recognition, and 168th hospital in the U.S. There are now seven hospitals in Colorado and 370 in the world with this prestigious recognition.
The Magnet program was created after a study by the American Association of Nurses in the 1980s looked at how some hospitals were able to recruit and retain nurses. From that, the forces of magnetism were created. Magnet hospitals have lower turnover, higher nursing satisfaction, lowers incidents of falls, pressure ulcers and infections and more highly educated staff.
Reinhard said Magnet demonstrates the quality of patient care and the commitment of entire hospital to embrace it. Receiving the recognition a second time shows that Craig has continued to exceed the standards required for initial recognition, as the bar is raised with each four-year designation. And there are no guarantees that a hospital will receive subsequent Magnet designations.
"It demonstrates that nursing has worked really hard to truly operationalize the shared governance model and demonstrate that we meet the standards and feel passionate about what we do here," she said.
Reinhard, who celebrated her 20th year at Craig this year, was the director of nursing when Craig received its first Magnet status in 2005. She became CNO in early 2009, so this time around her role was a bit different. Magnet requires that the CNO has an active role in hospital decision making and sits on the board of directors, something that’s always been a standard at Craig, Reinhard said. She also had to ensure nurses had adequate time to be involved in professional organizations, community work and continuing education.
Although she had an active role in achieving the second Magnet designation, Reinhard praised Magnet Program and Clinical Scholar Coordinator Jeanine Rundquist, RN-MSN, CRRN, for doing the lion share of the work.
"Jeanine’s strength is really keeping us all on task and focused and she truly took a leadership role in organizing the documents," Reinhard said. "She has absolutely been the force behind helping us get everything in place to demonstrate that we meet the Magnet standards. The staff did a great job and she pulled it all together so it could be presented."
Rundquist is leaving Craig to work in quality improvement at The Children’s Hospital, and Reinhard said "she will definitely be missed."
Reinhard, MBA, MSCIS, BSN, RN, CRRN, NE-BC, started at Craig as nurse manger of the spinal cord injury unit and worked as director of nursing for seven years before taking over as CNO and VP of Patient
Care Services over a year ago. The supportive environment is what has kept her at Craig, whose leadership has encouraged her to grow, both professionally and personally with involvement in local and national professional organizations.
"I’ve been encouraged to look at not what the limits of the profession hold me to, and how I can touch many people inside and outside the walls of Craig," she said.
The philosophy of encouraging staff to try new things is one of the keys to Craig retaining its nurses for such long periods of time. "We allow the nursing staff to have many opportunities. We mix it up here," Reinhard said. To avoid what she calls "bedside burnout," nurses are given opportunities to pursue their interests. For example, Craig has a nursing fellowship position for nurses interested in doing research and a clinical scholar program for those who like to teach.
"There’s always something else you can do. It prevents you from feeling burned out and it challenges you in your position," Reinhard said. "It’s been that way throughout my career here at Craig." During the Magnet site visit in January, it was noted that Craig’s nurse-driven initiatives support nurses’ as autonomous and respected members of the medical team. Notably, the Spinal Cord Injury Nurse Advice Line, a nurse-driven program, was cited as an exemplar of innovation, application of evidence-based practice and quality patient care.
Another thing that helps the nurses stand out, Reinhard said, is their involvement in every hospital-wide committee, reinforcing the importance of the voice of nursing.
Craig’s nursing staff, which consists of about 135 RNs, 135 rehab techs and four LPNs, is able to develop long-term relationships with patients and families, whereas at other acute-care hospitals patients are often cared for and never seen again.
"As a health care provider it’s so rewarding to see the work that we did at the beginning pay off for the patient as well as their family and how that really looks on the outside," Reinhard said. "It continues to remind us that what we do matters."