Turner, Pamela PhD, APRN, CPN, NEABC; Milligan, Louise M.; Crady, Kim M. BSN, RN; Deputy, Lucinda BSN, RN, NE-BC; Whitefield, Carol H. BSN, RN, HNB-BC; Stiffler, Debra MSN, RN, NE-BC
EARLY IN ITS Magnet® journey, Baptist Health faced a considerable problem: It lacked a sufficient communication infrastructure to get all 8,000 of its employees on the same page at the same time. What it lacked in structure, however, it made up for in collaborative spirit. The organization had the will to collaborate and communicate about key Magnet concepts, so it formed the Magnet communication committee to create structures, strategies, and processes to bridge the organization's communication gaps across all disciplines and locations.
Gauging the gaps
Baptist Health began its Magnet journey by initiating an extensive internal gap analysis, which benchmarked units, facilities, and the system against Magnet criteria.
Results were compiled in a gap analysis matrix, which revealed pockets of missing data related to sources of evidence. Teams initiated additional analysis and partnered with system-level departments, such as finance and human resources, either to fill the gaps or to verify the absence of data.
Analysis of the completed matrix yielded two key insights. First, few gaps existed across the system. Where one hospital lacked evidence, another excelled in providing it. Second, no formal mechanisms were in place to replicate the successes and strengths of one facility at other facilities.
The system-wide oversight team, which was commissioned to strategically guide the organization through the Magnet process, categorized the results of the gap analysis into four areas:
* physician-nurse relationships and physician champions
* nursing education, practice, and shared governance
Multidisciplinary teams were formed around each of these areas, with the facilities selecting a representative for each team. The Magnet communication committee was one of four teams tasked with filling gaps and "connecting the dots" at the unit, facility, and system levels.
The Magnet communication committee's composition was roughly two-thirds nursing staff; the remaining one-third of the team comprised representatives from education, performance improvement, public relations, pharmacy, lab, and Internet administration. Certain committee members also served as site coordinators, the designated point persons to manage Magnet communication and feedback at each site. Acting as liaisons between the Magnet communication committee and their respective facilities, site coordinators ensured that the unique culture of each entity was incorporated into committee decisions and recommendations.
The Magnet communication committee developed its objectives: awareness (educating employees about the concept of Magnet), involvement (reinforcing the critical role each employee plays in delivering patient care), and engagement (fostering a sense of personal investment in the Magnet journey among staff at every level, in every discipline, and in every location). The communication process started with nursing, but multiple audiences were targeted over the 3-year effort, including physicians, board members, community partners, families, and patients.
Setting up a communication network
As a first step, the Magnet communication committee focused on building a network of Magnet champions to personally carry the basic "What is Magnet?" message to staff at the unit and department level. The concept of using face-to-face messengers to communicate personally and to both give and receive information was rooted in the organization's nursing model, which is based on caring relationships.
Magnet champions worked within their facilities to educate staff on Magnet, report staff feedback to the site coordinator, provide ideas for improving communication, and aid in collection of Magnet stories. The committee determined that a Magnet champion should have a strong interpersonal communication style and a good professional reputation. The organization also wanted to reflect Baptist Health's workforce demographics with appropriate representation of day and night shifts, staff-level employees and managers, and clinical and nonclinical areas. Using these guidelines, the Magnet communication committee and site coordinators worked together to identify Magnet champions at each facility. After supervisors were contacted for clearance, the recruitment process began.
Start with the basics
The committee was ready to start communicating the basic information everyone needed to know. To make the information visible around-the-clock at the unit and department level, bulletin boards were installed throughout each facility. Informative posters were produced monthly by the committee and distributed to each unit and department. Each poster zeroed in on a key Magnet component and gave sources of evidence at Baptist Health.
The topic of every monthly Magnet poster was reinforced through intense communication using multiple methods:
* An information table staffed by Magnet champions and site coordinators was set up in the main lobby of each facility once a month.
* Print communications reinforced Magnet concepts via the monthly employee news magazine, as well as the CNO newsletter.
* Magnet rounds were conducted with all shifts on a rotating basis, allowing nursing leadership, site coordinators, Magnet champions, and Magnet communication committee members to interact with and get feedback from staff on the front lines.
Recognizing that communication is a journey, not a one-time event, members of the Magnet communication committee understood that they couldn't communicate effectively to everyone at once or move everyone at the same pace. Resistance and skepticism are common with anything new or unfamiliar. One of the most important strategies for overcoming resistance is active listening. For this reason, throughout the multi-year process, leadership and Magnet champions continued to round with a Magnet focus. When common themes emerged across more than one setting, the Magnet communication committee was alerted and engaged to develop a system-wide messaging focus.
A new communication hub
The Baptist Health employee intranet played a critical role as the go-to place for information about Magnet, bringing a geographically dispersed organization together under one umbrella. The home page of this section of the intranet was reorganized accordingly and named Magnet Central.
But Magnet Central wasn't just for one-way dissemination of information; it was interactive and personal. Staff members could go there to take quick quizzes, see the countdown clock, view the latest photos, find out who won the most recent Magnet contest, and submit Magnet stories.
Everybody has a Magnet story
After awareness of the Magnet model was established, the challenge was getting nurses and staff involved and engaged in the Magnet journey. To this end, the Magnet communication committee challenged employees to tell their own Magnet stories and provided each staff member with a fold-out "My Magnet Story" card, which they attached to their badges.
To capture team stories, an electronic comment card was added to Magnet Central and 265 stories were collected from throughout Baptist Health over 6 months. The Magnet communication committee read each story, assigned applicable Magnet components, and published them on the intranet, with the contributor's approval. Several of the stories were expanded into articles for the organization's employee newsletter and the local newspaper.
Continuing the momentum
No matter where an organization is in its Magnet journey, sustaining a high level of energy and engagement is always challenging. New people must be recruited into the fold while continuity of leadership is retained.
After Baptist Health achieved Magnet recognition, it worked to reengage and expand its champion network, as well as the Magnet communication committee itself. In addition, site co-coordinators now facilitate the sharing of Magnet responsibilities and help build the next generation of Magnet leadership. They let staff members rotate out of their Magnet roles when necessary, and thank them for their contributions.
Another challenge is to determine when a new strategic focus for messaging is required. The keys to strategic communication are knowing what the target audience thinks or does now and defining the desired change in mindset or action. For Baptist Health, that tension between current and desired state defines its current journey—a journey about using evidence-based practice (EBP) to achieve empirical outcomes. This is why Baptist Health kicked off the next leg of its Magnet journey under a new theme called "Step It Up and Step It Out" to convey the call to apply EBP throughout the system, in every environment of care. To help accomplish this, the communication strategy uses the Magnet model (with empirical outcomes at the center) as the organizing structure whenever possible.
Use of electronic communication has also been stepped up and the role of the intranet expanded. For example, the 2009 nursing annual report content was organized according to the five Magnet components and published only on the intranet. Magnet Central has been reorganized and all Magnet-related content on the web has been indexed according to those same five components.
In addition, nursing excellence award categories were based on the Magnet model. Everything has been tied together by using the same graphic and the same language.
Besides repetition and consistency of key messages, personal engagement opportunities must be established. People need stimulation to think about and experience things in a new way and to engage positive emotions. It can be a powerful learning experience for those who participate in creative self-expression about the Magnet journey.
With this in mind, the Magnet communication committee has continued to use Magnet poster contests, with the first one entitled "What quality means to me/us." A competition can spark creativity and interest across the system.
Winning teams and their posters were recognized in the employee newsletter and on Magnet Central. Prizes were awarded to winning team members. Grand prize winners were invited to a reception hosted by the CEO. Every level of the organization must be integrated in recognizing the importance of this work.
The renewal loop
Building feedback loops into the Magnet communication plan is the single most important learning experience of the Magnet communication committee. This ear-to-the-ground approach is essential to keep the Magnet effort fresh and interesting to people over time, and it allows the committee to modify its plan to quickly address issues, barriers, and opportunities.
For Baptist Health, those feedback loops continue to include people (Magnet champions, Magnet council leadership) and processes (submitting stories and feedback online, participating in system-wide Magnet council meetings, attending physician meetings). Having multiple feeders into one central hub (the Magnet communication committee) that operates with oversight from executive leadership enables the communication infrastructure to incorporate new energy and ideas while staying grounded in a disciplined communication process that requires consistency and integration.
Using some of the communication principles and tactics outlined here, and modifying them as needed to fit the culture of your organization, a Magnet communication committee can play a pivotal role in helping an organization of any size achieve Magnet success.
© 2012 Lippincott Williams & Wilkins, Inc.