Turner, Pamela PhD, APRN, CPN, NEA-BC; 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 its collaborative spirit. The organization had the will to collaborate and communicate about key Magnet concepts; it simply lacked a way to engage all employees system-wide in sharing practices, ideas, and feedback in a timely and effective manner. The Magnet Communication Committee was formed to create structures, strategies, and processes to bridge the organization's communication gaps across all disciplines and locations. In doing so, the committee helped create the most successful system for communication and employee alignment in the organization's history.
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. Nursing leaders and nursing clinical staff from each hospital collaborated to design and implement the analysis. Teams of four were assigned Magnet components and tasked with researching the related sources of evidence at each facility. Teams allocated 1 day per week for 4 months to conduct crosswalks, collect information, engage in face-to-face discussions, and research hospital policies, procedures, and practices. This comprehensive, cross-facility approach resulted in an objective assessment of how each facility was meeting sources of evidence.
Results were compiled in a gap analysis matrix, which revealed pockets of missing data related to sources of evidence. The 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 evidence. 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: (a) physician-nurse relationships and physician champions; (b) nursing education, practice, and shared governance; (c) research; (d) and communication. 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, and the remaining one-third of the team was comprised of representatives from education, performance improvement, public relations, pharmacy, lab, and Internet administration. Certain committee members also served as site coordinators, the designated point person to manage Magnet communication and feedback at each site. 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 it's important to note that 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 the unit and department level. The concept of using face-to-face messengers to communicate personally and bidirectionally 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 increasing communication effectiveness, and aid in the collection of Magnet stories. The committee determined that the skill set of a Magnet champion should include a strong interpersonal communication style and good professional reputation. To communicate effectively, champions needed to be able to build on an existing basis of trust, acceptance, and credibility.
In addition to seeking highly trusted and motivated individuals, the organization 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
Having recruited Magnet champions and created a face-to-face communication structure, 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. Informational 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 Magnet champions encouraged staff to take it to the next level by decorating unit and department bulletin boards with their own photos and stories demonstrating each featured Magnet component.
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. On these "Magnet Mondays," brief interactions with staff brought attention to basic Magnet concepts via drawings for movie tickets and other small prizes.
* Print communications reinforced Magnet concepts via the monthly employee news magazine, as well as the CNO newsletter. In fact, a special edition of the employee newsletter was dedicated to the Magnet journey.
* Magnet rounds were conducted with all shifts on a rotating basis, allowing nursing leadership, site coordinators, Magnet champions, and Magnet Communication Committee members to have helpful interaction with and get feedback from staff on the front lines. Interactive games such as Magnet Jeopardy were played, and snacks were given to participants. This approach helped to dispel the misperception among staff that the Magnet site visit was similar to a Joint Commission site survey.
Recognizing that communication is a journey, not a one-time event, the Magnet Communication Committee understood that it couldn't communicate effectively to everyone at once or move everyone at the same pace. With anything new or unfamiliar, there's always resistance and skepticism. One of the most important things you can do is actively listen. For this reason, throughout the multiyear 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.
For example, Magnet champions detected that some influential staff members felt that Magnet was a burdensome new initiative, adding a new layer of complexity to their already-full plates. Armed with this insight, the Magnet Communication Committee created the slogan, "That's Magnet!" to help staff recognize that the evidence of Magnet already existed in their daily work. Thereafter, a small icon reading "That's Magnet!" identified stories of Magnet at work in the employee newsletter. The effect was energizing.
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 use of the intranet started as an online file cabinet for council minutes and meeting schedules, but the Magnet Communication Committee realized quickly that all employees could benefit from a one-stop hub for Magnet educational materials and news. The home page of this section of the intranet was reorganized accordingly and named Magnet Central.
When a poster or a newsletter promoted Magnet, there was almost always reference to finding out more on Magnet Central. In this way, printed and online communications cross-referenced one another. Most importantly, 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, see who won the most recent Magnet contest, and submit Magnet stories.
Accessible to employees from home or work, Magnet Central depicted Magnet in action throughout the entire healthcare system. Employees who worked off-site or who might not visit the lobby to see Magnet Monday displays could see photo galleries. Newly hired employees could also quickly become a part of the journey.
The relevance of Magnet Central is reflected in its growth and, more importantly, its utilization. In November 2005, Magnet Central had 7 pages, which were viewed 1,002 times during that month. Nearly 2 years later, those numbers had dramatically increased. By September 2007, Magnet Central consisted of 208 pages, which were viewed 5,247 times during that month.
Everybody has a Magnet story
After awareness of the Magnet model was established, the challenge was to shift to getting nurses and staff to feel 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 in a 6-month period. The Magnet Communication Committee read each story, assigned applicable Magnet components, and published them on the intranet, with the contributor's approval. The author and any coworkers/volunteers mentioned in the story were given a printed copy of the story and a Magnet journey pin created by the committee. Where possible, the letter and pin were presented ceremoniously to the author during a unit or department meeting. 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, there are always challenges in sustaining a high level of energy and engagement. This is why it's critical to continue to recruit new people into the fold while retaining as much continuity of leadership as possible.
After Baptist Health achieved Magnet recognition, it worked to re-engage and expand its champion network, as well as the Magnet Communication Committee itself. In addition to site coordinators, there are now site co-coordinators to facilitate sharing of Magnet responsibilities and build the next generation of Magnet leadership. It's equally important to allow staff members to rotate out of their Magnet roles when necessary and thank them for their contributions. Everyone on the team must be able to contribute to the momentum in some way.
Another challenge is to determine when a new strategic focus for messaging is required. The keys to strategic communication are to know what the target audience thinks or does now and define 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 is to use the Magnet model (with empirical outcomes at the center) as the organizing structure for everything 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 indexed according to those same five components. A series of informational Magnet posters were created at the rate of one every 6 to 8 weeks, with each focused on a single component of the model. Rather than printing these posters with examples of sources of evidence, they were distributed electronically with a blank for each unit or department to fill in with its own story. In addition, nursing excellence award categories were based on the Magnet model. It has been a conscious and ongoing effort to tie everything together, using the same graphic and the same language.
Beyond repetition and consistency of key messages, the importance of establishing personal engagement opportunities can't be underestimated. It takes more than information to change people's mindsets—it requires 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." Posters are a way of making work that's often invisible more visible and accessible to everyone. Perhaps the most important fundamental aspect of this tactic is to create clearly defined guidelines that align with goals. The act of creating a poster becomes even more engaging when a competitive component is added to the exercise. It sparks 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, every step of the way.
The renewal loop
The single most important learning experience of the Magnet Communication Committee is to build feedback loops into the Magnet communication plan. This ear to the ground approach is essential to keeping 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 when they arise.
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.
© 2011 by Lippincott Williams & Wilkins, Inc.