Princes Alexandra Hospital’s

Magnet Journey:

Developing a Strong and

Capable Workforce

Darren Clark

a/Nursing Director, Workforce and Patient Flow

Princess Alexandra Hospital

Metro South Health and Hospital Service

(MSH)

MSH

Metro South Health & Hospital Service (MSHHS) is a large health district

serving an estimated population of 1 million people, approximately 23

percent of the Queensland‟s population.

Metro South activity profile in 2009-2010

• 176,333 patients admitted

• 218,288 emergency department presentations

• 977,933 outpatient appointments

• 41,877 operations performed

• 419,538 medication items dispensed

• 371,438 occasions of services to community and primary health

Metro South Workforce by Headcount

Managerial and

Clerical

14%

Medical incl VMOs

13%

Nursing

43%

Operational

15%

Trade and Artisans

1%

Professional and

Technical

14%

Managerial and Clerical Medical incl VMOs Nursing

Operational Trade and Artisans Professional and Technical

Princess Alexandra Hospital (PAH)

PAH

• Tertiary – Adult

• Trauma centre – South

Brisbane

• Statewide spinal and

brain injury service

• Transplant and cancer

• Other specialties

PAH

PAH – Nursing Workforce

Princess Alexandra Hospital 2000

Agency Usage Record

High

Bed Closures

Vacancy Rates 12%

Turnover 25-28%

A New Hospital

The Facts – PAH

• 2000

Independent Company - Nursing Cultural Survey

• Staff Feedback:

Leadership/Management skills

Communication

Visibility of Leaders

Retention Factors

Message in a bottle

• Results of Culture = BLAME

http://www.nursecredentialing.org/magnet.aspx

The Vision

• Evidence Based quality program focuses on

optimal environments for Nurses and Patients

• Magnet facilities demonstrate:

1. High Staff Culture

2. Patient Satisfaction

3. Lower turnover rates

• Better Patient outcomes

Magnet Recognition Program

Magnet Recognition Program© is a:

• International Evidence Based Quality Accreditation Program

• 3 Decades of Research proving Magnet© Accredited Healthcare facilities have

higher nursing culture

nursing retention

lower vacancy rates

better patient outcomes.

PAH Nursing Services:

• Used MRP© outcome criteria as a benchmark quality framework

• Leadership and Management strategies aimed to create a „Magnet‟© culture

The Challenge

• To be recognised as a Magnet Facility

• an organisation must demonstrate an optimal

work environment

• Undertake a gruelling evaluation to identify if

stringent criteria under 5 Components are met.

Leadership & Management Strategies

The PAH utilised the criteria as a

benchmark to develop Strategies

which would rebuild Nursing Services

Transformational

Leadership

• Vision for future direction

• Committed, Energetic

• Visible

• Strong leadership

• Dedicated, Passionate

• Has the ability to transform an organisations (Bass, 1990)

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taff

Paulin

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oss

Vero

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asey

PAH EDNS

Leadership & Management Strategies

Magnet Champions

2004 – 60 Magnet Champions

Today – 370 Magnet Champion

Role:

Educate clinical units

Evaluate ward environment

Today:

Role formalised

Clinical Ladder Education

Pathway

Leadership & Management Strategies

Learning Ladder

Tools developed to enable staff to evaluate

patient environment

2005 Unit Specific Nursing Scorecard

Aim: Direct care nurses with a snap

shot report enabling staff to review, analyse,

benchmark NSI

2009

ACHSE Review – “Excellent Initiative”

Aim: Develop a standardised reporting process to capture

NSI

2009

2012 – Statewide NSI

Tools developed to enable staff to

evaluate nursing environment

2005 Magnet Quality Workbook

2009 90% Completion Rate

2012 Magnet Quality Workbook on-

line

Enhance image of nursing

Hospital Posters –

• Educating all Staff of the

• benefits of Magnet:

• Screen Savers, Hospitals Posters,

• Ward Posters

Enhance image of nursing

Enhance image of nursing

2007 – 2012

Nursing Thankyou Card - International Nurses Day

Enhance image of nursing

Magnet Expo 2004 and 2008

International Nurses Day

Web Page

Professional Practice Model

1. Creating a culture of

excellence

2. Clarifies expectations

3. Accountability for

practice

4. Achieving high quality

healthcare

5. Staff satisfaction

Reward and Recognition

• Foster a culture of

growing performance

through building

capability and capacity to

reward high performance

• Develop and implement a

formal reward and

recognition plan that

recognises outstanding

achievement for practice

Peer Review

• Enhance self awareness

• Support continuous

learning

• Recognise and build

strengths and positive

behaviours

• Structured and

constructive way of

understanding impact on

others

Magnet Recognition Program Outcomes

2004 1st Hospital in Southern Hemisphere to be

Designated Magnet©

Magnet Recognition Program Outcomes

2009

1st International Hospital to be Re-Designated

Magnet©

Magnet Recognition Program Outcomes

2009: Scored 8 „Exemplars‟ during Magnet© Re-

Designation for exceptional nursing practice

• Quality of Nursing Leadership – 1 Exemplar

• Management Style – 1 Exemplar

• Professional Models of Care – 1 Exemplar

• Consultation and Resources – 1 Exemplar

• Nursing Autonomy – 2 Exemplars

• Community and the Healthcare Organisation – 2

Exemplars

Magnet Recognition Program Outcomes

2012:

Nursing and Midwifery Office, Queensland

recommended PAH establish QH first Centre of

Nursing Excellence Clinical Performance,

Nursing Standards and Innovation to provide

leadership and mentorship in elements of

the Magnet Recognition Program©

BPA Results at PAH

Type of engagement culture

Turnover and Length of Health Service

With over 13,000 employees only 1,125 staff separated from Queensland Health in 2010/11. This

equates to a turnover rate of 8.61% which has decreased compared to 9.78% in 2009/10

The trending of the PAH‟s Turnover risk from 2002 to 2011 appears in the graph below (a low

score is a good outcome). Since 2002, the PAH has reduced its Turnover risk by 13%.

PAH’s turnover risk at 26% is significantly lower than the norm 40%

PAH Nursing Vacancy Rate

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Risk in Culture

Nursing BPA results

Employee Attraction – Nursing

Employee Retention – Nursing

Changes Since Last Survey

OUR CHALLENGES

Potential impacts to attracting and retaining our employees

have also been acknowledged by:

• The expected opening of the Transitional Research Institute (TRI) in 2012

• The new Gold Coast Hospital expected to open in 2013

• The Queensland Children‟s Hospital expected to open 2014

• Innovation and implementation of the national eHealth initiatives

• Ongoing competition and attraction for our staff by the private sector

Our Challenges – Nursing

• Magnet Re-designation 2013

• Maintaining and improving culture, resilience

and educational standard in current fiscal

environment

• Improving patient outcomes and NSI‟s

• Maximising workforce efficiencies and

effectiveness

Princess Alexandra Hospital

Designated Magnet 2004-2008

Re-designated Magnet 2009-2013