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

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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.


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


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.


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.


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.

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