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Nursing Management:
doi: 10.1097/01.NUMA.0000393001.11257.a5
Feature: THE MAGNETIC PULL: SPECIALTY FOCUS: MAGNET(R) HOSPITAL

Utilizing decision acceleration for Magnet® gap analysis

Kempnich, Jodeena M. MSN, RN

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Jodeena M. Kempnich is the manager of Nursing Service Administration and the Magnet program director at Alegent Health Bergan Mercy Medical Center in Omaha, Neb.

Incorporating evidenced-based practice (EBP) into learning activities doesn't require extraordinary skill. All that's needed is to gather proof that your lessons help individuals become better learners. This article will discuss and analyze evidence-based learning activities in the decision acceleration process related to conducting a gap analysis with the goal of obtaining Magnet® designation.

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Best practices for education

EBP can be applied to show how and why educational services are important to students' learning.1 Billings and Connors discuss seven best practices for education:

* time on task

* high expectations

* rich, rapid feedback

* active learning

* interaction with faculty

* interaction with peers

* respect for diversity.2

Friedman and Fisher outline 14 instructional strategies into three categories: process strategies to enhance students' learning and adaptation, teaching strategies to increase students' learning, and strategies to manage the classroom by use of appropriate time dimension.3 For example, deciding to hold daylong decision acceleration off campus and involving all of the key players versus several on campus meetings over several weeks meets the best practice of use of appropriate time dimension.

These best practices can be applied to the decision acceleration process utilized to conduct a gap analysis to achieving Magnet status. Decision acceleration is a proven approach to rapid, sound decision making.4 The outcome of the gap analysis is to identify where "gaps" exist between the organization's examples and descriptions of practices to demonstrate the sources of evidence requested by the Magnet Recognition Program. ®

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The nuts and bolts of decision acceleration

Alegent Health in Omaha, Neb., was among the first healthcare providers to put decision acceleration to work in a not-for-profit healthcare system.4 This process is performed at the "right track," taking the right people (representative stakeholders) and the right tools (innovative thinking, consensus building, and horizon planning) in the right place (space constructed expressly for the purpose of dialogue, decision making, and planning) to make the right decisions (shared vision and recommended horizon plan).4

Allocating realistic amounts of time means effective learning for participants and effective teaching.5 It was easy to provide ample learning time and keep learners on task in the innovative environment of decision acceleration. Participants don't waste time due to the fast pace and high expectations required. The decision acceleration process accelerates work, stimulates innovation, and engages participants to drive toward a common purpose.4 The expectations were set from the start that all participants would be activity engaged—expect more and you get more. Expecting learners to perform well becomes a self-fulfilling prophecy when teachers and institutions hold high expectations for themselves and make extra efforts.5

Learning is enhanced when it's more like a team effort and not a solo race.6 Good learning, like good work, is collaborative and social, not competitive and isolated. The learning activities at the decision accelerator promoted a cooperative learning environment, encouraged the free exchange of ideas, and allowed for different ways of learning. Teaching strategies to increase students' learning included the best practices of rich, rapid feedback and active learning.2 According to Billings and Connors, "students learn best when they are actively engaging with the content."2 This is why the decision acceleration method works so well.

In an atmosphere of trust and collaboration, well-rounded dialogue occurs with a common purpose to "get to the heart of key issues."4 Each participant is encouraged to share; it's an open environment where all individuals are there for the same purpose. Learning isn't a spectator sport.6 Participants don't learn much just by sitting in classes listening to teachers, memorizing, and regurgitating answers. They must talk about what they're learning, write about it, relate it to experiences, and be able to apply it in practice.5 Decision acceleration encompasses that experience.

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Process steps

First, we divided our large group into small groups of six to eight participants each. Each small group was given the assignment of reviewing their assigned Magnet component, determining whether supporting evidence is available for each source of evidence needed, and determining what documents or products are to be used as sources of evidence. Then each group was asked to determine the difficulty level of collecting evidence and rank as either "easy," "moderate," or "hard." Lastly, the group was asked to determine who will be responsible for collecting evidence. Dedicated space is an essential tool for decision acceleration, along with support staff.4 Whiteboards were utilized to document findings. Digital pictures were taken of the whiteboards so recording could occur later and keep the focus of the participants.

After the initial small group activity, the gap analysis was conducted in round robin style. One member from the initial group remained behind to explain the group's work while the rest of the group traveled to another group. Each group reviewed what other members completed. During the round robin, participants were encouraged to add to the initial work. Although each activity could stand on its own, by combining several of these teaching strategies the learner remains highly engaged.

Giving feedback immediately is one of the key components of the decision acceleration process. Knowing what you know and don't know focuses learning.6 Appropriate feedback was given throughout the day, both on the process and on the content. Repetition was utilized effectively by repeating the whole process two more times during the day to finish the gap analysis of the Magnet Recognition Program.

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Taking it to the next level

Decision acceleration is a good example of a learning environment that stimulates the learner. It's a learner-centered process, where the participant plays an active role. There's a strong sense of shared purpose, support from administration, and consistency with the purposes of making decisions and continually examining to see how well the purposes are being achieved.4 Objectives of the gap analysis are met in a logical, well-thought-out process.

Characteristics of the participants involved in the decision accelerator showed readiness to learn. Emotional readiness was high, with motivation and engagement present, experiential readiness, aspiration of achieving the goal, and a basic knowledge base with the desire to know more. Ongoing, robust communication was vital, with the result being a deeper commitment to the outcome.4 Participants interacted with peers in a cooperative, collaborative environment in which learning was a shared activity.

There are many roads to learning and people bring different talent and styles of learning to the table.5 The aspiration to change one's culture to "world class" motivates staff members to change behaviors and strive for goals that aren't easily attainable. The goal of achieving Magnet recognition will take your organization to the next level, just as EBP takes education to a higher level.1 Individuals benefit by shaping important attitudes and values and creating a more effective learning environment.1

Conducting a Magnet decision acceleration is the best practice to utilize when organizations are conducting a gap analysis because it's fast-paced and outcome-orientated.

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REFERENCES

1. Todd RJ. Irrefutable evidence: How to prove you boost student achievement. http://www.schoollibraryjournal.com/article/CA287119.html.

2. Billings DM, Connors HR. Best practices in online learning. http://www.electronicvision.com/nln/chapter02/index.htm.

3. King J, Sattler-Weber S, King K. Instructional strategies for distance education: Research based examples. http://www.uwex.edu/disted/conference/Resource_library/proceedings/02_35.pdf.

4. Sensor W, Schwab T. Building committed relationships through accelerated decision making process. 2006 Client Education Conference. Professional Research Consultants, Inc.

5. Bastable SB. Nurse As Educator: Principles of Teaching and Learning for Nursing Practice. 2nd ed. Toronto, Canada: Jones and Bartlett; 2003.

6. Chickering AW, Ehrmann SC. Implementing the seven principles: Technology as lever. http://www.tltgroup.org/programs/seven.html.

© 2011 by Lippincott Williams & Wilkins, Inc.

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