The nursing program and staff at Meridian Health are internally encouraged to excel and fulfill their professional potential. The organization boasts excellence in patient-centered care, a thoroughly trained staff, state of the art facilities and they have garnered the accolades, awards and ratings to demonstrate this. They provide exemplary health care to their patients across nursing units, and have cultivated an exceptional work environment as proven in their staff retention. Meridian’s organizational structure features departmental checks and balances. For instance, Meridian has developed many committees for inner governance and oversight to ensure patient satisfaction, job satisfaction, continue implementing evidence based nursing practice, ethics in research, and organizational values of empowerment and integrity.
Amongst the nursing staff, Meridian has achieved great success. Richard Hader (2013), the Chief Nursing Officer reports a vacancy rate of less than 1% amongst nursing staff. He also highlights the fact that half the 2,000 JSUMC nurses are nationally certified in their clinical specialty. Additionally important are the extra contributions that the nursing staff provides for Meridian in education and research. The staff is encouraged to participate in oversight committees, nursing congresses, the CARE program, and other shared governance activities. Another accolade that JSUMC has achieved is in maintaining the lowest post-operative cardiac mortality rates even though they have the second highest volume of bypass procedures in the state of New Jersey.
Meridian has won many national and regional awards for performance and exemplary health care. They are the first system in the United States to receive Magnet recognition from the American Nurses Credentialing Center and are now considered “a national leader in the delivery of quality nursing care” (Hader, 2013). Each year Meridian Health publishes a formal document that lists all the accomplishments, awards, and special certifications of the nursing staff. In their last annual publication of Excellence in Action, Meridian Health showcased hundreds of nurses and their prestigious honors and awards (national, regional and private foundation awards).
Nurses at Meridian Health are offered the opportunity to evaluate their model of care through nationally benchmarked methods such as the respected Gallup employee satisfaction and NDNQI RN satisfaction surveys (Exemplary Professional Practice, p. 3). Additional evaluation and care quality measures include: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data, Surgical Care Improvement Project (SCIP), and NDNQI clinical outcomes data. Some important evaluation measures include “core indicators across all settings” for each nursing unit. Some of them are:
Number of CARE nurses by unit
CARE participation is at 63% (“Excellence in Action”, 2012)
Number of nationally certified nurses
Patient satisfaction scores (Press, Ganey or HCAHPS Assessments)
(“Exemplary Professional Practice”, p. 3).
Through these evaluations and assessments, nursing staff identified the “shared governance component” of the nursing practice model and organizational structure as the component that needed “further development” (Exemplary Practice, p. 4). Another weakness in nursing participation and shared governance activities was attendance. Although there are committees and venues for participating, voicing concerns, oversight and other governance and professional activities, nursing attendance was inconsistent. What is unclear is if nurses are given enough time in their workday to be able to attend regularly and contribute to the organizational value of shared governance. Also, if committee meetings and activities are not well coordinated, they may overlap with other duties and activities that prohibit representation from all nursing units, undermining the inclusive nature of shared governance activities.
Another organizational concern or critique is aimed at the small executive staff. There are only six members in upper management for the entire nursing staff and it seems unlikely that those six staff members can deal with all of the organizational demands of a nursing staff of 2,000, plus the interaction of over 3,000 volunteers annually. A suggestion might be to make middle management more transparent in order to make the top six senior management more accessible to staff. It seems that they are overstretched because in the Meridian publications Exemplary Professional Practice and Excellence in Action, these executives are sitting in and participating on various committees and nursing congresses. A question arises as to whether this type of participation is the best use of their time and if these activities give them enough visibility amongst all nursing units.
In summary, Meridian Health and Jersey Shore University Medical Center are achieving excellence in holistic patient centered health care. Also, it is apparent that Meridian is outperforming other health care systems around the country, as is evident in their Magnet recognition from the American Nurses Credentialing Center, and the vast range of services they offer to their patients. Also, their emphasis in continuing education, mentorship programs and nurse certification motivates their nursing staff to continually evolve professionally. However, on the dimension of shared governance, the organization scores low, and must attend to this if they want reach their ideal culture profile.