The Magnet® Site Visit: Going Virtual in Response to COVID-19.

The coronavirus disease (COVID-19) pandemic has been a source of disruption, unexpected illness, stress, and adversity for people, worldwide. As the reality of the COVID-19 pandemic unfolded in early 2020, many healthcare organizations found themselves in the midst of their Magnet appraisals-just short of the 3rd appraisal phase, the Site Visit Phase. In response, the Magnet Recognition Program devised strategies to maintain the integrity of the appraisal process, despite the turbulence associated with the unexpected changes that healthcare organizations were confronting while contending with the impact of COVID-19. In this month's Magnet Perspectives column, we explore how the virtual site visit has provided healthcare organizations with the opportunity to complete this phase of their appraisal process while addressing the safety and well-being of the organization's staff as well as that of the Magnet appraisers.

Embedding a Professional Practice Model Across a System.

Professional practice models (PPMs) are an integral part of any organization on the Magnet® journey, whether initial designation or redesignation. Through the journey, the PPM should become embedded within the nursing culture. Leadership at multiple levels is crucial to ensure successful adoption and implementation.

Nurse Fatigue and Shift Length: A Pilot Study.

Increasing emphasis on patient quality and concerns about the impact of health care worker fatigue has stimulated efforts for leaders to address patient quality and caregiver satisfaction. Shift length has been associated with nurse fatigue and has become a growing concern in the United States with the routine shift length of 12 hours. In this project, shift lengths from 12 hours to 8 hours for a 4-week period to evaluate fatigue levels associated with 12-hour and 8-hour shifts. Lessons learned from this experience: nurses are agreeable to try a proposed change, numerous ideas should be tried to develop additional innovative solutions to the issue of nurse fatigue, and nurses may not want to work 5 days per week.

Excellence and evidence in staffing: a data-driven model for excellence in staffing (2nd edition).

The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research and innovative thinking about nurse staffing across all health care settings, a second goal is to stimulate additional publications. This includes a goal of at least 20 articles in Nursing Economic$ on best practices in staffing and care models from across the continuum over the next 3 years.

Interprofessional teams in the patient-centered medical home.

The implementation of patient-centered medical homes has reinforced the need for interprofessional practice as the means to increasing patient quality. The nurse executive is well positioned to facilitate interprofessional collaborative practice; however, more sophisticated and focused strategies are needed for high levels of interprofessional partnerships that wholeheartedly ensure patient-driven health care. This article presents strategies to meet the needs of the patient as the interprofessional team coordinates activities across the continuum. Strategies include having a clear understanding of the patient-centered medical homes concept, clear articulation of patient centricity behaviors, selection of metrics that are actionable, competence in developing high-functioning partnerships, and processes to strengthen the organizational cultural to support interprofessional practice.