Units of Distinction: Creating a Blueprint for Recognition of High-Performing Medical-Surgical Nursing Units.

BACKGROUND: Hospital medical-surgical (M/S) nursing units are responsible for up to 28 million encounters annually, yet receive little attention from professional organizations and national initiatives targeted to improve quality and performance.

OBJECTIVE: We sought to develop a framework recognizing high-performing units within our large hospital system.

METHODS: This was a retrospective data analysis of M/S units throughout a 168-hospital system. Measures represented patient experience, employee engagement, staff scheduling, nursing-sensitive patient outcomes, professional practices, and clinical process measures.

RESULTS: Four hundred ninety units from 129 hospitals contributed information to test the framework. A manual scoring system identified the top 5% and recognized them as a "Unit of Distinction." Secondary analyses with machine learning provided validation of the proposed framework.

CONCLUSIONS: Similar to external recognition programs, this framework and process provide a holistic evaluation useful for meaningful recognition and lay the groundwork for benchmarking in improvement efforts.