Innovation amidst radical cost containment in health care.

The changing health care environment is requiring nurse executives within a hospital setting to design and implement innovative workforce practices that will both improve patient outcomes and lower costs. Since registered nurses comprise the largest percentage of a hospital's workforce, finding ways to incorporate them in these efforts is essential. The Magnet Recognition Program through the American Nurses Credentialing Center is one successful evidence-based strategy that can be adopted to engage nurses in quality improvement processes.

Challenges in sustaining excellence over time.

A culture of excellence is not synonymous with a culture of perfection. Perfection is not attainable but excellence is when an infrastructure is developed that can rapidly and effectively adapt to change. Saint Joseph's Hospital in Atlanta, Georgia, is often asked about the challenges faced in developing, and sustaining, a culture of nursing excellence over time.