Building Research Infrastructure in Magnet® Hospitals: Current Status and Future Directions.

Objective: The aim of this study was to describe the infrastructures supporting research in Magnet® hospitals.

Background: Hospitals undertaking the journey toward Magnet designation must build research and evidence-based practice (EBP) infrastructures that support the infusion of research and EBP into clinical practice.

Methods: An electronic survey was developed and distributed to the chief nursing officer or Magnet coordinator of all Magnet hospitals between June 10, 2015, and July 8, 2015.

Credentialing: the need for a national research agenda.

A national research agenda is needed to promote inquiry into the impact of credentialing on health care outcomes for nurses, patients, and organizations. Credentialing is used here to refer to individual credentialing, such as certification for nurses, and organizational credentialing, such as American Nurses Credentialing Center Magnet recognition for health care organizations or accreditation of providers of continuing education in nursing. Although it is hypothesized that credentialing leads to a higher quality of care, more uniform practice, and better patient outcomes, the research evidence to validate these views is limited.

A mile in their shoes: interdisciplinary education at the Johns Hopkins University School of Medicine.

An elective course exposing medical students to nonphysician hospital providers and staff was conceived and implemented. Goals and objectives identified were to (1) increase students' understanding of the roles of nonphysician professionals in hospital care, (2) demonstrate how the services offered by these professionals complement those offered by physicians, (3) improve students' skill in communicating with nonphysician professionals, (4) develop students' comfort approaching these professionals about patient care issues, (5) show students "what it is like" to be each of these providers, and (6) demonstrate the common challenges they face. A 2-week elective rotation paired students with experienced preceptors in several nonphysician hospital care disciplines.

Paying the piper: investing in infrastructure for patient safety.

Background: Although the best allocation of resources is unknown, there is general agreement that improvements in safety require an organization-level safety culture, in which leadership humbly acknowledges safety shortcomings and allocates resources at the patient care and unit levels to identify and mitigate risks. Since 2001, the Johns Hopkins Hospital has increased its investment in human capital at the patient care, unit/team, and organization levels to improve patient safety.

Patient Care Level: An inadequate infrastructure, both technical and human, has prompted health care organizations to rely on nurses to help implement new safety programs and to enforce new policies because hospital leaders often have limited ability to disseminate or enforce such changes with the medical staff.

Senior executive adopt-a-work unit: a model for safety improvement.

Background: At The Johns Hopkins Hospital (JHH), the patient safety committee created a safety program that focused on encouraging staff in selected units to identify and eliminate potential errors in the patient care environment. As part of this program, senior hospital executives each adopted an intensive care unit and worked with the unit staff to identify issues and to empower staff to address safety issues. JHH PATIENT SAFETY PROGRAM: The program consisted of eight steps, which together require six months for implementation: (1) conduct a culture survey; (2) educate staff on the science of safety; (3) identify staff safety concerns through a staff safety survey; (4) implement the senior executive adopt-a-work unit program; (5) implement improvements; (6-7) document results, share stories, and disseminate results; and (8) resurvey staff.