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Hallmark Health System (HHS) is one of only eight hospitals in the state, and less than 7 percent of hospitals in the United States, to achieve Magnet® recognition as a reflection of its nursing professionalism, teamwork and superiority in patient care. HHS is the only system in New England to receive this recognition.

Magnet® recognition is determined by the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program®, which ensures that rigorous standards for nursing excellence are met. With this credential, HHS joins the Magnet® community, a select group of 401 health care organizations out of nearly 6,000 U.S. health care organizations.

Magnet® recognition has become the gold standard for nursing excellence and is taken into consideration when the public judges health care organizations. In fact, U.S. News & World Report’s annual showcase of “America’s Best Hospitals” includes Magnet® recognition in its ranking criteria for quality of inpatient care.

The Magnet® appraisers and commission reported that it was clear from the “board room to the bedside” that HHS has set a vision and focus on quality and safety. They applauded HHS for being a role model for other Magnet® hospitals in the following areas:

  • Hospital programs dedicated to helping newly licensed nurses successfully transition to specialty areas of practice including the residency programs in Maternal-Newborn Services, Emergency Departments and the Medical-Surgical Telemetry Float Team.
  • The hospital’s commitment to providing programs and services that serve the health care needs of our communities.
  • The extensive use of research by nurses at all levels, noting that a culture of clinical inquiry is evident throughout the system.


To achieve Magnet® recognition, organizations must pass a rigorous and lengthy process that demands widespread participation from leadership and staff and includes demonstrating qualitative and quantitative evidence regarding patient care and outcomes and a rigorous onsite review process. Hallmark Health’s designation was achieved with a unanimous vote of approval by the Commission.

In particular, the Magnet® Model is designed to provide a framework for nursing practice, research and measurement of outcomes. Through this framework, ANCC can assess applicants across a number of components and dimensions to gauge an organization’s nursing excellence. The foundation of this model is composed of various elements deemed essential to delivering superior patient care. These include the quality of nursing leadership and coordination and collaboration across specialties, as well as processes for measuring and improving the quality and delivery of care.


Our healthcare system

HHS, a community hospital system, consisting of two campuses and many outpatient centers, serves the population north of Boston, and is committed to the provision of quality patient care and dedication to the community. These commitments remain central to the organization’s mission, vision and core values with patient care as the cornerstone. HHS organizes goals and priorities across the HHS Cornerstones, to assure we are advancing across all of them and are ‘connecting the dots’ of interdependence. The Cornerstones include Growth, People, Quality, Service and Finance. The clinical care delivered at HHS has been recognized repeatedly by external sources.

The Department of Nursing’s mission, vision, values and philosophy were derived from those of the institution. Congruent with the HHS organizational mission, the mission of the HHS Department of Nursing is to provide quality care to the patients and families of the communities we serve. This mission fosters a nursing culture, which promotes nurse leadership and autonomy, professional development, critical thinking and cultural competence. The Department of Nursing vision states, “As professional nurses and members of the nursing care team, our most important responsibility is achieving positive outcomes for our patients and nursing staff. It is through our professional practice model that we fulfill our vision.” The HHS Nursing Philosophy states that in concert with the mission, vision and values of HHS, the professional nurse, with the support of the care team, embraces the following commitments to the internal and external community:

  • We embrace respect as the cornerstone of our actions, supporting each other as well as the needs of our patients and their families while valuing cultural, ethnic and religious diversity regardless of race and social standing. We believe in upholding the dignity and worth of every member of our health care family and every patient we serve.
  • We believe that by functioning within our professional standards of practice, we provide safe, quality patient care. Through our professional model of care delivery we promote competence, compassion, communication and critical thinking in health promotion and disease prevention across the continuum of life.
  • We believe as professional nurses we practice autonomously with accountability and responsibility in managing and coordinating patient care. We are committed to advocating for patients to achieve optimal outcome oriented care.
  • We are committed to collaboration with the entire health care team to provide the highest quality holistic patient and family-centered care.
  • We are dedicated to providing comprehensive care guided by ethical principles and utilizing sound judgment.
  • Our unique culture of caring embraces a shared governance model which promotes involvement of each individual toward the achievement of common goals.
  • We believe that through a life-long commitment to our individual and collective professional growth and development, we promote optimal patient outcomes relying on the best of research and experience.
  • It is in utilizing and sharing our experiential wisdom that we cultivate an environment of excellence and high professional and personal satisfaction.

The nursing strategic plan and goals are developed annually after a review of the institution’s strategic plan and goals that have been put forth by senior management. This process assures that institutional and departmental strategies and priorities are aligned and form the basis for development and achievement of individual goals.

 

To join our nursing team

To learn more about nursing opportunities at Hallmark Health, click here to view our openings. For questions regarding openings at Melrose-Wakefield Hospital, call the Human Resources Department at 781-979-3764. For questions regarding openings at Lawrence Memorial Hospital, call the Human Resources Department at 781-306-6565.


Professional Practice Model

The HHS professional practice model is the foundation of nursing practice, guides the nursing strategic plan, fosters the development of goals and is supported by the shared governance structure. The professional practice model drives how nurses practice, collaborate with other members of the healthcare team, communicate and develop professionally to provide the highest quality patient care. The professional practice model is in alignment with and integrated with the nursing mission, vision and values. The philosophy of nursing at HHS is grounded in the passionate belief that the needs of the individual patient direct the nursing care received by the patient. Nursing care at HHS is patient-centered and characterized by a mutually respectful nurse-patient relationship and framed within the care delivery model- Synergy. The HHS Professional Practice Model consists of the shared governance structure, the professional recognition program, nursing peer review, the nursing quality plan and the synergy model of care. Professional Model components are held together and supported by HHS structure and processes outlined in policy and procedures, ANA Scope and Standards of Practice and the ANA Code of Ethics. The professional governance model maintains and enhances nursing practice through empowerment and point of service decision-making. Nurses at all levels are empowered to affect decision-making through the shared governance structure and the support provided by the Chief Nursing Officer.

Integrated with this professional practice model is the Synergy Model of care delivery, which describes a patient-nurse relationship that supports the primacy of patients. With this framework, patient needs are matched to a nurse’s level of expertise to deliver the best nursing care possible. Direct care nurses at HHS are actively involved with the development, application, evaluation, adaptation and modification of the professional practice model via strategic planning, the shared governance structure and participation on interdisciplinary committees and teams. To sustain their individual and collective commitment to excellence in nursing practice, HHS nurses continually evaluate the systems and structures that affect the care of patients. The review process includes appropriateness based on current scientific and nursing knowledge, relevant clinical, ethical and legal concerns and, as appropriate, findings from quality improvement and other evaluation methods.


Synergy Professional Model of Care

The Hallmark Health System professional model of care is the Synergy Model – a holistic model where patient/family needs are matched to a nurse’s level of expertise, which directly contributes to optimal patient outcomes. The Synergy Model specifically describes relevant aspects of the nurse-patient, nurse-nurse and nurse-system relationships. The Synergy Model, developed by the American Association of Critical Care Nurses, describes a patient-nurse relationship that supports the primacy of patients and families. All nurse-patient/family assignments are based upon matching patient/family needs to nurse competencies.

Introduction The Synergy Model describes a cluster of personal characteristics that each patient and family brings to a healthcare situation. These 8 characteristics are dynamic and span a continuum of health to illness and include: stability, complexity, vulnerability, predictability, resiliency, participation in decision-making, participation in care, and resource availability. Nursing competencies, derived from the needs of patients, are also described in terms of evolving professional practice. The Synergy Model describes eight dimensions of nursing practice that span the continuum from competent nurse to master clinician nurse. These include clinical judgment, clinical inquiry, caring practices, response to diversity, advocacy/moral agency, facilitation of learning, collaboration and systems thinking. These competencies reflect a dynamic integration of knowledge, skills, experience, and attitudes needed to meet patient’s needs and optimize patient outcomes. The Hallmark Health System professional advancement program is based upon evolving expertise within these eight dimensions of nursing practice.

Within the Synergy Model and consistent with patient/family-centered-care, patients and families are, or assisted to become, active participants in the patient/family-nurse interaction. The interaction is synergistic; specifically, it is reciprocating and co-constituting. The nurse comes to “know” the patient and family and the patient and family comes to “know” the nurse. When this relationship demonstrates engagement and synergistic then optimal patient outcomes are more apt to occur.

Core Values

  • We believe that excellence in care is provided through meaningful therapeutic relationships with patients and their families, continuity in care is a core element of our model of care.
  • In support of fostering therapeutic patient/family-nurse relationships, the Clinical Nurse Leaders and Staff Nurses work together to build continuity in nursing care over the patient’s illness trajectory by assigning a limited number of nurses to the patient/family.
  • As colleagues, more experienced nurses mentor less experienced nurses.
  • Since the needs of patients vary across the system, we have a varying number of Staff Nurses and Advanced Practice Nurses who provide varying levels of expertise on each unit to best accommodate patient needs.


Assumptions: Each patient and family is unique with various capacities for health and vulnerability to illness. Patients possess a singular genetic and biological makeup that establishes their capacity for health. Each individual practices various degrees of healthy behaviors, for example, healthy diet, exercise, and stress reduction. Each lives in a community with different economic structures, government, social organization and community perceptions. All exist within a macro social structure consisting of societal infrastructure, the physical environment, cultural characteristics, and population perceptions. All these factors place the patient in context of an individual within a unique environment and circumstance that impacts the nursing care required of the particular patient and family.

Patient Characteristics of Concern to Nursing
Stability is the ability to maintain a steady state. Stability can be used to describe any vacillating phenomena that impacts nursing care; for example: physiological stability, psychological stability, emotional stability, family or social stability.

Complexity is defined as the intricate entanglement of two or more systems. This characteristic includes multiple systems and/or therapies, for example, body systems, family and social systems, and/or therapeutic interventions.

Vulnerability is a susceptibility to stressors that may adversely affect patient outcomes. Patient vulnerability considers the patient’s risk for adverse outcomes. For example, individuals may present with co-morbid conditions that place them at high risk for associated adverse outcomes and/or patients receiving certain therapies may be at risk for associated complications. Anticipatory assessment and management of associated risks or co-morbid conditions impacts the patient’s nursing care and recovery.

Predictability is the characteristic that allows one to expect a certain trajectory of illness. While most patients have a predictable course of illness, some individuals do not respond in the typical fashion. When predictable, the patient’s care can be managed using traditional practice guidelines; when unpredictable, practice guidelines are not helpful. Also, when the patient or their diagnosis is unknown, one cannot anticipate the patient’s response to interventions or predict the patient’s trajectory of illness.

Resiliency is the capacity to return to a restorative level of functioning using compensatory and coping mechanisms. Given the patient’s individuality, some patients easily return to a stabile state where others do not. How a nurse approaches and plans interventions that may challenge the patient’s stability is certainly based upon the individual’s capacity to restore homeostasis.

Participation in decision-making describes the extent to which the patient or family engages in decision-making. The patient’s and family’s capacity, desire, and level of decision-making in daily management and overall treatment vary dramatically within the care environment. At different points during their illness, the nurse stands in for, or beside a patient and family to support them though a decision that will impact their care and management.

Participation in care describes the extent to which the patient and family participates in care activities. Again, the patient’s and family’s capacity, desire, and level of participation in care vary dramatically within the care environment. At different points during their illness, the nurse either provides or helps the patient and family give care.

Resource availability is the extent of resources the patient, family, or community brings to the care situation. Resources include personal, physiological, social, technical and financial. The extent of available resource impacts the level of support nurses need to provide patients and their families.

Nurse Competencies of Concern to Patients and Their Families
The Synergy Model nurse dimensions are used to frame nursing competence within Hallmark Health System. The competencies form the basis of the nursing job descriptions. Evolving expertise in each dimension is linked to the Hallmark Health System Department of Nursing Professional Recognition Program. As individual nurses level’s of expertise are determined, an optimal balance of clinician, advanced clinician, expert clinician and master clinicians on a unit is determined based upon the patient population served.

Clinical judgment is the ability of nurses to use their clinical knowledge to affect patient outcome. It is defined as clinical reasoning, which includes clinical decision-making, critical thinking, and a global grasp of the situation, coupled with nursing skills acquired through a process of integrating formal and experiential knowledge. Patricia Benner’s From Novice to Expert has enriched how the Nursing profession has come to understand clinical knowledge development. Clinical wisdom is not solely dependent on years of experience but on experience gained from years of learning and applying knowledge gained to each successive patient.

Clinical inquiry involves resolving clinical problems that occur at the bedside and in the care environment. It is an ongoing process of questioning and evaluating practice and providing informed practice and creating practice changes or innovation through research utilization and experiential learning. It is a matter of asking good questions, delving into the literature to answer those questions, and bringing the best evidence to the bedside. Clinical inquiry is all about seeing, questioning, finding the evidence, and making practice changes.

Caring practices makes our clinical judgment visible. Caring practices include a constellation of nursing activities which are responsive to the uniqueness of the patient and family and that create a compassionate and therapeutic environment with the aim of promoting comfort and preventing suffering. Caring practices, such as presence and vigilance, create a safe environment for patients to be sick in. Caring practices, extended to all members of the care team, creates a therapeutic milieu. Caring practices include not only what nurses do but also how they do it. Pain assessment and management are fundamental caring activities. Nurses are engaged during difficult situations, they help the patient and families understand and decide out how best they can get though tough situations. All patients are unique with different values and beliefs that nurses learn so they can know what is important to the patient and their family.

Response to diversity involves the sensitivity to recognize, appreciate, and incorporate differences in the provision of care. Differences may include, but are not limited to: individuality, cultural differences, spiritual beliefs, gender, racial, ethnicity, family configuration lifestyle, socioeconomic status, age, values, alternative medicine involving patients/families and members of the healthcare team. Nurses help families identify, for themselves, what is important to them as individuals and support them though difficult decisions.

Advocacy/moral agency involves working on another’s behalf and representing the concerns of the patient/family/community and serving as a moral agent in identifying and helping to resolve ethical and clinical concerns within the clinical setting. Because of Nursing’s unique relationship with patients and families, nurses often are the voice for patients who cannot speak for themselves. Nurses carry on the moral tradition of nursing and serve as the patient and family’s moral agent; the person in whom things matter, the person who takes a stand and gives voice to patient and family concerns.

Facilitator of learning refers to nurses’ competency in facilitating patient, family and staff learning. This includes supporting a learning environment characterized by safe discourse, mentoring and team development. Teaching and patient and family learning is embedded in care, from our first interaction, where we orient patients and family to the care environment, to our last interaction, where we finalize instructions for home. We also assume major responsibility in coaching and mentoring the next generation of nurses and members of the interdisciplinary team.

Collaboration includes working with others (patient, family, healthcare providers, colleagues, community) in a way that promotes and encourages each person’s contributions. Collaboration involves intradisciplinary and interdisciplinary work with colleagues and ability to negotiate and resolve conflict. The nurse is the one person who knows the care environment and can pull a team of caregivers together in the best interest of the patient and family.

Systems’ thinking includes appreciating the care environment from a perspective that recognizes the inter-relationships that exist within and across healthcare settings. Making complex systems safe for patients is a skill. Whereas competent nurses operative on a micro level (unit and shift focus) and are just beginning to develop system savvy and strategies to facilitate change, expert nurses operate on a macro level (program and episode of illness focus), possess system savvy and easily apply a variety of strategies to facilitate change within complex systems.

References

American Nurses Association (2003). Nursing’s social policy statement (2nd ed.). Washington, DC.

Expertise in Nursing Practice: Caring, Clinical Judgment and Ethics. Benner, P., Tanner, C., Chesla, C., (1996). Clinical Wisdom and Interventions in Critical Care: A Thinking in Action Approach. Springer Publishing Co.

Benner P. (1984). From novice to expert: excellence and power in clinical nursing practice. Addison-Wesley Publishing Co., Inc.

Curley MAQ. Synergy: From Theory to Practice. Synergy: Continued. Origins of Synergy. Synergy in Publication. In MAQ. Curley (Editor). The State of Synergy. Excellence in Nursing Knowledge 2004; 1(1) www.nursingknowledge.org/enk

Curley, M.A. (1998). Patient-nurse synergy: optimizing patients' outcomes. American Journal of Critical Care, 7(1), 64-72.

Curley, M., & Wallace, J. (1992). Effects of the nursing participation model of care on parental stress in the PICU: a replication. Pediatric Nursing, 7(6), 377-385.

Curley, M. (1988). Effects of the nursing mutual participation model of care on parental stress in the PICU. Heart Lung, 17(6), 682-688.

Hagerty, B., & Patusky, K. (2003). Reconceptualizing the nurse-patient relationship. Journal of Nursing Scholarship, 35 (2). 145-149.

Tanner, C.A., Benner, P., Chesla, C., Gordon, D.R. (1993). The phenomenology of knowing the patient. Image, 25, 273-280.

The Massachusetts Nurse Practice Act: Massachusetts General Laws (M.G.L) chapters 13, 14, 14a, 15, 15d and chapter 112, 74-81c of 244 CMR sections 3.00-9.00


The DAISY Award for Extraordinary Nurses

In 2008, Hallmark Health System (HHS) joined over 600 healthcare organizations throughout the country in the DAISY Foundation. DAISY stands for “Diseases Attacking the Immune System”. The organization was founded November, 1999 in memory of J. Patrick Barnes who died at 33 from complications of ITP (Idiopathic Thrombocytopenia Purpura).

The DAISY Foundation was established to honor nurses. The Barnes family was awestruck by the care and compassion Pat received from his nurses during his 8 week hospitalization. DAISY recognizes and says thank you to nurses by:
• Honoring the super-human work nurses do at the bedside every day.
• Funding research: The J. Patrick Barnes Grants for Nursing Research and Evidence-Based Practice Projects
• Honoring nursing faculty: The DAISY Faculty Award

The American Organization of Nurse Executives (AONE) and its chapters collaborate to help expand DAISY to hospitals throughout the United States. American Nurse Credentialing Center (ANCC) supports The DAISY Award for all Magnet® and Pathways to Excellence organizations – and those on the journey.

Who can nominate the Nurses? Nominations can be submitted by patients, families, colleagues, physicians, and other staff. The DAISY award is focused on the compassionate care and memorable moments nurses provide their patients … as well as great clinical skill. Every nomination tells a story. To nominate a nurse, please  click here  to submit your story.

Hallmark Health System DAISY Awards winners:

May 2008
Talin Barsoumian, MSN, RN-BC West 3 Lawrence Memorial Hospital
Kathy Ledoux, RN Medical 3 Melrose Wakefield Hospital

August 2008
Beth Reid, BSN, RN, PCCN Medical 5 Melrose Wakefield Hospital
Marissa Tribble, RN West 2 Lawrence Memorial Hospital

November 2008
Jennifer Yap, BSN, RN Medical 5 Melrose Wakefield Hospital
Kathy Charbonnier, BSN, RN, CCRN West 3 Lawrence Memorial Hospital

February 2009
Gerry Goulet, BSN, RN South 1 Lawrence Memorial Hospital
Barbara Harris, BSN, RN, PCCNMedical 3 Melrose Wakefield Hospital

May 2009
Marjorie Moss, BSN, RN, CCRN Medical ICU Melrose Wakefield Hospital
Michelle Harrington, BSN, RN, CCRN ICU Lawrence Memorial Hospital

October 2009
Nicole Bates, BSN, RN, PCCN Medical 5 Melrose Wakefield Hospital
Francesca Nepomuceno, ASN, RN West 3 Lawrence Memorial Hospital

March 2010
Jennifer Ulicny, BSN, RN System Float Team Hallmark Health System

November 2010
Hilary Otway, ASN, RN West 3 Lawrence Memorial Hospital
Kellie Story, ASN, RN Medical ICU Melrose Wakefield Hospital

May 2011
Karen Masucci, ASN, RN West 2 Lawrence Memorial Hospital
Sharon Turcotte, BSN, RN-BC, CWS Staff Development Hallmark Health System
Beverly Turino, RN Medical 3 Melrose Wakefield Hospital

January 2012
Mary Hughes, RN Managed Care Melrose Wakefield Hospital
Julie Maloof, RN West 3 Lawrence Memorial Hospital
Jennifer Barnes, ASN, RN-BC Medical 6 Melrose Wakefield Hospital

 


Guiding Principles

  • Consistent and Visible Support

  • Mutual commitment to learn and grow together
  • Trust

  • Belief in the character and competence of each other, including clinical competence, interpersonal competence, cultural competence, leadership competence, and critical thinking ability
  • Mutual Respect

  • Recognizing the intrinsic value of each member of the care delivery team
  • Open and Honest Communication

  • Belief in the importance of direct, open, honest and timely communication

Hallmark Health Nursing Philosophy

In concert with the mission, vision and values of Hallmark Health, the professional nurse, with the support of the nursing care team, embraces the following commitments to our internal and external community:

  • We embrace RESPECT as the cornerstone of our actions, supporting each other as well as the needs of our patients and their families while valuing cultural, ethnic and religious diversity regardless of race and social standing. We believe in upholding the DIGNITY and WORTH of every member of our health care family and every patient we serve.
  • We believe that by functioning within our professional standards of practice, we provide safe, quality patient care. Through our care delivery model we promote COMPETENCE, COMPASSION, COMMUNICATION and CRITICAL THINKING in health promotion and disease prevention across the continuum of life.
  • We believe as professional nurses we practice AUTONOMOUSLY with ACCOUNTABILITY and RESPONSIBILITY in managing and coordinating patient care. We are committed to ADVOCATING for patients to achieve optimal outcome oriented care.
  • We are committed to COLLABORATION with the entire health care team to provide the highest quality holistic patient and family-centered care.
  • We are DEDICATED to providing comprehensive care guided by ethical principles and utilizing sound judgment.
  • Our unique culture of caring embraces a SHARED GOVERNANCE MODEL which promotes involvement of each individual toward the achievement of common goals.
  • We believe that through a life-long commitment to our individual and collective professional growth and development, we promote optimal patient outcomes relying on the best of research and experience.
  • It is in utilizing and sharing our experiential wisdom that we cultivate an environment of excellence and high professional and personal satisfaction.

Professional Recognition Program
Downloadable DOC - 209kb


Mission

The mission of the Hallmark Health Department of Nursing is to provide quality care to patients and families of the communities we serve. This mission fosters a nursing culture which promotes nurse leadership and autonomy, professional development, critical thinking and cultural competence.

Vision

As professional nurses and members of the nursing care team, our most important responsibility is achieving positive outcomes for our patients and nursing staff. It is through our professional practice model that we fulfill our vision.


National League for Nursing

The Lawrence Memorial/Regis College Nursing Program as part of Regis College School of Nursing and Health Professions has been designated a Center of Excellence in Nursing Education by the National League for Nursing (NLN). It is the first NLN Center of Excellence designation in New England and there are fewer than 25 in the country.

Each year since 2004, the NLN has invited nursing schools to apply for this designation based on their ability to demonstrate sustained excellence in faculty development, nursing education research, or student learning and professional development. Schools must also have a proven commitment to continuous quality improvement.latestnln

 

 

 

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