Magnet

Pulling together to achieve excellent care

An exciting bid to ensure that South London and Maudsley NHS Foundation Trust (SLaM) attracts and retains a nursing workforce that consistently delivers the highest standards of care to service users is well underway.

The three-year project, known as the Magnet Recognition Programme, should culminate by the end of 2012 with SLaM becoming the first NHS trust in this country to gain the prestigious 'Magnet status'.

After the Trust submits detailed information on the 145 indicators set out in the application, covering topics ranging from how many nurse managers hold degrees to measures of nurses' satisfaction levels with their work settings, a small team of assessors from the US will spend several days at SLaM verifying the information.

Origins of Magnet
Magnet, an internationally recognised programme, was created in the early 1980s by the American Academy of Nursing, which wanted to show why some hospitals could achieve much higher standards of care than their counterparts, and in a more consistent way.

Though most of the 380 hospitals with Magnet accreditation remain US-based, word is spreading across the globe and hospitals in Lebanon, Singapore and Australia have now joined the fold.

Aiming for accreditation
SLaM's programme is being funded to the tune of £435,000 by the trust's charitable funds committee, boosted by a significant cash injection of around £70,000 towards staffing costs from the Institute of Psychiatry, King's College London.

Dr Jane Sayer, Programme Director for Nursing Excellence and Magnet Recognition, says significant progress has already been made in gaining the nursing workforce's backing for the programme, which is currently around the mid-way point. "I am particularly pleased by the support we have received from staff delivering direct care to service users. But it's probably fair to say that we have made more progress on the inpatient side than in the community so far," she states.

"Last June we conducted a "gap analysis" to see how far away we were from being ready to apply for Magnet recognition. This was done by using a traffic lights system, with red showing more work was required on a specific aspect, for example, and green showing where we were fully prepared. In June, we found there was a very mixed picture but by the end of July we probably have more green than reds and ambers already."

Our application
It is often said that the United States and the UK are two countries divided by a common language, and, to some extent, this saying is likely to resonate with Dr Sayer as she grapples with the paperwork associated with applying for Magnet accreditation.

"Some aspects are proving quite "sticky". But that's generally to do with the cultural insensitivities of the tools we have to use, which are very American focused," she says.

"Trying to translate these tools both into a UK and a mental health context is proving quite difficult at times, and I may end up needing assistance from a US-based consultant to help us liaise with the American Nurses Credentialing Center, which overseas the Magnet programme."

Dr Sayer, who held the post of deputy director of nursing at the Trust for a number of years before being seconded into her current role in January 2010, has imported another initiative from the US - the Daisy awards - into the trust as a way of 'recognising and celebrating nursing excellence'.

"We have had a lot of freedom to do what we wanted with these awards. We had our first awards ceremony in June at which we gave awards out to six registered nurses and one healthcare assistant. There are 24 awards available over the year, and we are just about to invite applications for our second round of nominations.

"This is significant as not only are we the first British organisation to be signed up to the Daisy Foundation awards, we are the first European organisation to do so. It has, however, been supported by organisations in Asia, South America and Australia."

Dr Sayer's efforts are bolstered by a team of 17 ambassadors who have been freed up from their role in giving direct care to join her initiative for half a day each week. "These are members of direct care staff who have links with specific clinical areas and have gone out there and talked to people about what Magnet means."

What does it mean for patient care?
How would she define the Magnet approach? "Magnet is about ensuring the care that patients receive - particularly from nurses - is of the highest standard, and that is assured through a process of checking, monitoring and the setting of standards of excellence for people to achieve.

"It's not just a 'tick box' approach, it's about constantly attending to how well we are doing."

What differences might a member of staff spot once SLaM has achieved Magnet status? "They should notice, for example, that either they or a colleague should have a direct line through to a senior member of the organisation," Dr Sayer explains.

"In this way, they should be able to share good ideas and hear about what services are doing. They should also have a better idea about where their service sits in the wider organisation."

Feeding into these changes will be the fruits of work underway in the CAGs (Clinical Academic Groups) on care pathways, helping to show how nurses can intervene most effectively in patient care, Dr Sayer notes.

"We are really committed to ensuring that our nurses have the competencies they need to do the job we want them to do, and that we have a clearer focus about what that job is."

Dr Sayer is happy to admit that she and her nursing colleagues at SLaM have embarked on a "terrifying but exciting journey. If we achieve Magnet status, it will be a real achievement - particularly for a UK mental health hospital, which is so unlike anything they will have encountered before."