Creative Health Care Management - Cultures of Excellence Needs Assessment

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1. Organization Name

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2. Your Role/Title

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3. Email Address

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4. Magnet® Status:

Not pursuing

Planning to pursue

In progress

Re-designation

Magnet®-designated

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5. Pathway to Excellence® Status:

Not pursuing

Planning to pursue

In progress

Re-designation

Pathway to Excellence®-designated

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6. Type of Setting:

Academic Medical Center

Community Hospital

System or Enterprise

Critical Access Hospital

Long- Term Care/ Post- Acute

Ambulatory/ Outpatient

Other (please specify)

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7. What are your top 3 nursing or organizational priorities for the next 12–24 months?

Magnet® designation or re-designation

Pathway to Excellence® designation or re-designation

Wellbeing- Excellence™ program

Professional/shared governance implementation or revitalization

Leadership development or succession planning

Culture transformation

Nurse retention and engagement

Psychological safety and team well-being

Mentoring

Patient experience and patient outcomes

Evidence-based practice or research

Other (please specify)

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8. On a scale of 1–5, how confident are you that your organization is fully resourced to achieve these priorities? (1 being not at all confident and 5 being fully confident)

Clear

i We adjusted the number you entered based on the slider’s scale.

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9. Which of the following are the current challenges in your organization? (Select all that apply)

Inconsistent leadership practices across units

Low engagement in shared decision-making

Staff burnout or emotional exhaustion

Gaps in professional development pathways

Difficulty sustaining professional governance

Unclear accountability structures

Poor interprofessional collaboration

Lack of infrastructure for nursing excellence

Other (please specify)

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10. What types of offerings would be most helpful to your organization? (Select up to 5)

Microlearning modules for point of care staff

On-demand leadership development courses

Shared/Professional governance retreats/intensives

Professional practice retreats/intensives

Council leader toolkits/templates

Psychological safety training

Well-being offerings

EBP/Research mentorship/coaching

Custom consulting packages

Readiness or culture assessments

Digital dashboards for governance tracking

Virtual peer networking forums

Other (please specify)

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11. What format(s) do you prefer for learning and support?

Live virtual workshops

In-person facilitation

Online courses

Self-paced e-learning

Coaching/mentorship programs

Toolkits/templates

Other (please specify)

Creative Health Care Management - Cultures of Excellence Needs Assessment

Question Title

1. Organization Name

Question Title

2. Your Role/Title

Question Title

3. Email Address

Question Title

4. Magnet® Status:

Question Title

5. Pathway to Excellence® Status:

Question Title

6. Type of Setting:

Question Title

7. What are your top 3 nursing or organizational priorities for the next 12–24 months?

Question Title

8. On a scale of 1–5, how confident are you that your organization is fully resourced to achieve these priorities? (1 being not at all confident and 5 being fully confident)

Question Title

9. Which of the following are the current challenges in your organization? (Select all that apply)

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10. What types of offerings would be most helpful to your organization? (Select up to 5)

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11. What format(s) do you prefer for learning and support?

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12. What service, product, or support do you wish existed that could make a meaningful difference for your nurses or leaders?

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13. Any additional thoughts, needs, or suggestions you’d like to share?

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14. Would you like a member of our team to follow up with you?

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15. If yes, what’s the best time/method to reach you?

Creative Health Care Management - Cultures of Excellence Needs Assessment

Question Title

* 1. Organization Name

Question Title

* 2. Your Role/Title

Question Title

* 3. Email Address

Question Title

* 4. Magnet® Status:

Question Title

* 5. Pathway to Excellence® Status:

Question Title

* 6. Type of Setting:

Question Title

* 7. What are your top 3 nursing or organizational priorities for the next 12–24 months?

Question Title

* 8. On a scale of 1–5, how confident are you that your organization is fully resourced to achieve these priorities? (1 being not at all confident and 5 being fully confident)

Question Title

* 9. Which of the following are the current challenges in your organization? (Select all that apply)

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* 10. What types of offerings would be most helpful to your organization? (Select up to 5)

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* 11. What format(s) do you prefer for learning and support?

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* 12. What service, product, or support do you *wish existed* that could make a meaningful difference for your nurses or leaders?

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* 13. Any additional thoughts, needs, or suggestions you’d like to share?

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* 14. Would you like a member of our team to follow up with you?

Question Title

* 15. If yes, what’s the best time/method to reach you?

1. Organization Name

2. Your Role/Title

3. Email Address

4. Magnet® Status:

5. Pathway to Excellence® Status:

6. Type of Setting:

7. What are your top 3 nursing or organizational priorities for the next 12–24 months?

8. On a scale of 1–5, how confident are you that your organization is fully resourced to achieve these priorities? (1 being not at all confident and 5 being fully confident)

9. Which of the following are the current challenges in your organization? (Select all that apply)

10. What types of offerings would be most helpful to your organization? (Select up to 5)

11. What format(s) do you prefer for learning and support?

12. What service, product, or support do you wish existed that could make a meaningful difference for your nurses or leaders?

13. Any additional thoughts, needs, or suggestions you’d like to share?

14. Would you like a member of our team to follow up with you?

15. If yes, what’s the best time/method to reach you?