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Princes Alexandra Hospital’s
Magnet Journey:
Developing a Strong and
Capable Workforce
Darren Clark
a/Nursing Director, Workforce and Patient Flow
Princess Alexandra Hospital
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Metro South Health and Hospital Service
(MSH)
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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
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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
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Princess Alexandra Hospital (PAH)
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PAH
• Tertiary – Adult
• Trauma centre – South
Brisbane
• Statewide spinal and
brain injury service
• Transplant and cancer
• Other specialties
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PAH
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PAH – Nursing Workforce
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Princess Alexandra Hospital 2000
Agency Usage Record
High
Bed Closures
Vacancy Rates 12%
Turnover 25-28%
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A New Hospital
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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
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http://www.nursecredentialing.org/magnet.aspx
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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
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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
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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.
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Leadership & Management Strategies
The PAH utilised the criteria as a
benchmark to develop Strategies
which would rebuild Nursing Services
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Transformational
Leadership
• Vision for future direction
• Committed, Energetic
• Visible
• Strong leadership
• Dedicated, Passionate
• Has the ability to transform an organisations (Bass, 1990)
Joy V
ickers
taff
Paulin
e R
oss
Vero
nic
a C
asey
PAH EDNS
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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
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Leadership & Management Strategies
Learning Ladder
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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
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2009
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2012 – Statewide NSI
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Tools developed to enable staff to
evaluate nursing environment
2005 Magnet Quality Workbook
2009 90% Completion Rate
2012 Magnet Quality Workbook on-
line
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Enhance image of nursing
Hospital Posters –
• Educating all Staff of the
• benefits of Magnet:
• Screen Savers, Hospitals Posters,
• Ward Posters
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Enhance image of nursing
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Enhance image of nursing
2007 – 2012
Nursing Thankyou Card - International Nurses Day
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Enhance image of nursing
Magnet Expo 2004 and 2008
International Nurses Day
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Web Page
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Professional Practice Model
1. Creating a culture of
excellence
2. Clarifies expectations
3. Accountability for
practice
4. Achieving high quality
healthcare
5. Staff satisfaction
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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
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Peer Review
• Enhance self awareness
• Support continuous
learning
• Recognise and build
strengths and positive
behaviours
• Structured and
constructive way of
understanding impact on
others
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Magnet Recognition Program Outcomes
2004 1st Hospital in Southern Hemisphere to be
Designated Magnet©
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Magnet Recognition Program Outcomes
2009
1st International Hospital to be Re-Designated
Magnet©
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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
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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©
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BPA Results at PAH
Type of engagement culture
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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%
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PAH Nursing Vacancy Rate
0
20
40
60
80
100
120
140
160
Jan-
08
Feb-
08
Mar-
08
Apr-
08
May-
08
Jun-
08
Jul-
08
Aug-
08
Sep-
08
Oct-
08
Nov-
08
Dec-
08
Jan-
09
Feb-
09
Mar-
09
Apr-
09
May-
09
Jun-
09
Jul-
09
Aug-
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Sep-
09
Oct-
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Nov-
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Dec-
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Jan-
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Feb-
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Mar-
10
Apr-
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May-
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Month
FT
E
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Risk in Culture
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Nursing BPA results
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Employee Attraction – Nursing
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Employee Retention – Nursing
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Changes Since Last Survey
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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
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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
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Princess Alexandra Hospital
Designated Magnet 2004-2008
Re-designated Magnet 2009-2013