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The Official Baldrige Blog

Nurses Continue to Show Up—And Aspire to Excellence

Photo of staff at the American Association of Critical-Care Nurses congratulating the Cardiothoracic Intensive Care Unit for being the 2018-2021 Gold Beacon Award for Excellence winner.
Credit: AACN

Each day, millions of nurses report for their next shift, despite the still-high numbers of COVID-19 and other patients in need.

“They show up and give their all as they have their entire careers. Nurses chose this career intentionally, and each one brings a unique approach to care and leadership in nursing,” said Michelle Sanchez, MSN, RN, CPHQ, Beacon Program Manager at the American Association of Critical-Care Nurses (AACN). “Nurses have met the unprecedented and unexpected challenges of the COVID-19 pandemic head-on with compassion and science to continue doing all they can for patients and their families.”

For almost 20 years, AACN has been recognizing excellence in nursing units “that distinguish themselves by improving every facet of patient care” with the Beacon Award for Excellence®, Sanchez said. The award, partially based on the Malcolm Baldrige National Quality Award, began in 2003 as awareness was being raised nationally about patient safety and the cost of preventable medical errors.

The Beacon Award for Excellence

The Beacon Award recognizes units with three levels of designation—gold, silver, and bronze—that represent milestones in an excellence journey. Applicant units answer questions based on criteria adapted from the Magnet Recognition Program®, the Baldrige Award, and the National Quality Healthcare Award. In 2010, the Beacon criteria were realigned with the Baldrige Excellence Framework and its Criteria.

According to Sanchez, the Baldrige Award Criteria helped to create an understanding of how to evaluate performance, provide feedback, and support a journey to excellence. “The Baldrige Award, while used in health care, is not exclusive to health care. . . . Maintaining the alignment with the Baldrige Award has helped Beacon express its value and meaning to those with a business background whose support is needed to apply for Beacon.”

Sanchez added that applying for the Beacon Award is “often a transformative experience for a nursing unit and the individuals involved. . . . When they achieve the award, individuals feel such pride in having their efforts and work recognized by AACN.”

AACN processes Beacon Award applications with volunteer reviewers, segmented by experience and role: initial, senior, and administrative. The Beacon Award review panel prepares written feedback based on information provided by the applicant. The reviewers assign a score based on the evaluation dimensions of process and results that reflect a unit’s progress on its excellence journey.

Several hospitals who use the Baldrige Criteria and apply for Baldrige and Baldrige-based awards at national and state/local levels also proudly have Beacon Award-winning nursing units.

Chart showing the alignment of Beacon Award for Excellence Criteria with the Malcolm Baldrige National Quality Program. Found in the AACN Beacon Award for Excellence Handbook, page 22.
AACN Beacon Award for Excellence Handbook, page 22
Credit: AACN

“In many of these organizations, there is a commitment to excellence—a widespread belief, expectation, and support for the continual cycles of evaluation and improvement,” said Sanchez. “These organizations see the value of the pursuit of excellence, and they invest the necessary resources to be the movers and shakers of their industry.”

Sanchez explained why the pursuit of and recognition for excellence in nursing is so important to health care providers today. "I think where this becomes really important is that [the pursuit of excellence] quantifies what nurses do every day. Because nurses lead with empathy and compassion, it’s not always their forte to quantify what they’re doing. . . .

By participating in a performance improvement or performance excellence process, . . . you can start to put dollar signs and financial impact to nurses' contributions. So, for institutions where the nursing workforce is the highest expense in the health care system, it starts to show why nurses are so necessary.

Continuous Improvement Philosophy = Improved Outcomes

According to the AACN website, “Beacon awardees set the standard for excellence in patient care environments by collecting and using evidence-based information to improve patient outcomes, patient and staff satisfaction, and credibility with consumers.”

Sanchez said that excellence is “not just about your outcomes at the end of the day. It’s how did you get there and how do you make sure you get there all of the time. . . . [Striving for excellence] grounds everybody. It serves as the north star. So that when you need to pivot, there is no question . . . you know that this is the right thing. . . .

Those organizations—whether [they are pursuing awards for] Beacon or Baldrige—are going to take all of the information that they have at the moment and keep moving forward to do the best they can. . . .There’s such a philosophical difference when you have that in an organization.

According to an article “Value of excellence in Beacon units and Magnet® organizations” from the Critical Care Nurse journal,

  • Beacon Award-winning units have nurses with higher morale and lower turnover, who express higher satisfaction with their jobs, and who experience greater collaboration between colleagues and leaders;
  • the Beacon Award "provides opportunities for units to work together in a hospital to streamline processes and maximize efficiency, which can result in improved outcomes, including financial measures";
  • nurses also understand what the Beacon Award represents, thus it can be a tool to support nurse recruitment and retention, according to the AACN website, which adds, "for patients and their families, the Beacon Award signifies exceptional care through improved outcomes and greater overall satisfaction."

Part of nursing excellence is also establishing and sustaining healthy work environments. Sanchez said, “Units that are supported in their improvement efforts often cultivate a healthy work environment. . . . When innovation and improvement are supported, anything is possible.”

Sanchez cited the use of AACN’s Healthy Work Environment Standards, research-based standards to identify what makes a work environment healthy and leads to a better practice environment. Six standards were identified: authentic leadership, appropriate staffing, meaningful recognition, effective decision making, true collaboration, and skilled communication. Sanchez said AACN as an organization has also adopted the standards as its expectations and has seen other industries reference them.

American Association of Critical-Care Nurses

AACN is the standard-setting organization for critical care, which is the field of nursing with a focus on the care of critically ill or unstable patients following extensive injury, surgery, or life-threatening diseases. Based on research of nursing practices, AACN offers continuing education and different certifications that can often be applied to state boards of nurses. Celebration of Beacon Award-winning nursing units happens at AACN’s annual National Teaching Institute and Critical Care Exposition.

Nurses Will Continue to Show Up

While the Beacon Award recognizes excellence in nursing units, nurses have always provided the utmost care for patients.

Said Sanchez, “There have been so many amazing things that have happened in this past year. Very quickly nurses were closely monitoring their patients to understand the course of the virus and identify commonalities in what they were seeing. There has been a lot of innovation—particularly in relation to positioning patients for optimal breathing, optimizing safety amid changing [personal protective equipment] recommendations, communicating effectively with patients while wearing a mask, and maintaining communication with families who were not allowed in the hospital.”

She added, "Every day is a step forward in this long journey to deal with the COVID-19 pandemic. Nurses provide care and support to patients, families, and each other every day. . . . We still have a long road ahead of us, and nurses will continue to show up every day, regardless of the risks to their physical and emotional health; it is who we are. Everyone’s efforts to abide by the recommendations and actively participate in COVID-19 mitigation strategies will help us all reach the next normal."

2021-2022 Baldrige Excellence Framework Business/Nonprofit feature image

Baldrige Excellence Framework

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Available versions: Business/Nonprofit, Education, and Health Care

About the author

Dawn Bailey

Dawn Bailey is a writer/editor for the Baldrige Program and involved in all aspects of communications, from leading the Baldrige Executive Fellows program to managing the direction of case studies, social media efforts, and assessment teams. She has more than 25 years of experience, 18 years at the Baldrige Program. Her background is in English and journalism, with degrees from the University of Connecticut and an advanced degree from George Mason University.

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Congratulations on this achievement!

Speaking as a nurse, I would also like to point out that it's not "only" about the nurses. Nurses could not do what we do, and achieve the outcomes for each patient without the integrated effort of the entire team. COVID has certainly underscored the fact that "it takes the entire village" to achieve great outcomes in healthcare - physicians and nurses, certainly - as well as the therapies (respiratory, physical, and occupational), environmental services, plant operations, purchasing / supply chain, and everyone else providing for patients ... directly or indirectly.

So, kudos and "thanks" to everyone involved with the Cardiovascular ICU at Presbyterian - keep up the great work!

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