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Leading Change: A Case Study of the First Independent Critical-Access Hospital to Achieve Magnet® Designation
Heather V Nelson-Brantley1, Debra J Ford, Karen L Miller
1Author Affiliations: Assistant Professor (Dr Nelson-Brantley), Professor and Former Dean (Dr Miller), Adjunct Clinical Assistant Professor (Dr Stegenga), Associate Professor and Associate Dean for Research (Dr Bott), University of Kansas School of Nursing; Associate Professor (Dr Ford), Interdisciplinary Leadership Doctoral Program, Creighton University; Professor and Chair (Dr Lee), Health Policy and Management Department, University of Kansas Medical Center.
Objective:
The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®.
Background:
Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources.
Methods:
Staff nurses, nurse managers, interprofessional care providers, the chief nursing officer, and board of directors (n = 27) were interviewed. Observations of hospital units and administrative meetings were done, and hospital reports were analyzed.
Results:
Nine themes emerged to support a conceptual model of leading change. The CAH spent 3 years of its 6-year journey establishing organizational readiness. Nurses overcame complex challenges by balancing operational support and fostering relationships. The Magnet journey led to significantly improved nurse and patient outcomes. A new organizational culture centered on shared governance, evidence-based practice, and higher education emerged.
Conclusions:
The journey to Magnet leads to improved nurse, patient, and organization outcomes.
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