The study reveals emerging Magnet hospitals demonstrated markedly greater improvements in their work environments than other non-Magnet hospitals


The study reveals emerging Magnet hospitals demonstrated markedly greater improvements in their work environments than other non-Magnet hospitals



Over the past two decades since the American Nurses Credentialing Center introduced the Magnet Recognition Program to identify hospitals that demonstrate excellence in nursing, the number of Magnet hospitals in the United States has grown to more than 400.


The body of research on Magnet hospitals has grown over time, too, showing an association between Magnet status and better outcomes for both patients and nurses. However, little longitudinal evidence exists to support a causal link between Magnet recognition and improved outcomes.


A new study, one of the first longitudinal studies of Magnet hospitals, addresses that knowledge gap and suggests that when hospitals pursue Magnet status, they make lasting change at the patient, nurse, and organizational levels, challenging the assertion that Magnet hospitals have better outcomes because they were excellent to begin with.


The study, “Changes in Patient and Nurse Outcomes Associated With Magnet Hospital Recognition,” published in the June issue of Medical Care and funded by the Robert Wood Johnson Foundation (RWJF) Initiative on the Future of Nursing, examined 1999-2006 data from 136 Pennsylvania hospitals: 11 “emerging Magnets” that undertook the year-long application review process and 125 non-Magnets.


"The results of this research indicate that becoming a Magnet recognized hospital has a positive impact on not only nurses' work environment but also on patient outcomes,” said Amy Witkoski Stimpfel, PhD, RN, associate professor at NYU College of Nursing. “Since the majority of work in this area has been cross-sectional, and this study evaluates changes over time as hospitals move from being non-Magnet to Magnet recognized, it's a new contribution to the literature."


The researchers found that in 1999, hospitals pursuing Magnet status performed at the same level as or worse than non-Magnet hospitals on a range of measures, including risk-adjusted rates of mortality 30 days after surgery, and failure-to-rescue. By 2006, emerging Magnets had progressed significantly ahead of their non-Magnet counterparts, demonstrating markedly greater improvements, including 2.4 fewer deaths per 1,000 patients for 30-day surgical mortality, 6.1 fewer deaths per 1,000 patients for failure-to-rescue, and lower adjusted rates of nurse burnout, job dissatisfaction, and intent to quit.


The co-authors of the paper include Ann Kutney-Lee, PhD, RN, FAAN, assistant professor of nursing and Linda H. Aiken, PhD, RN, FAAN, professor and director of the Center for Health Outcomes and Policy Research at Penn’s School of Nursing.


“Our results add to the body of literature that links the quality of the nurse work environment to better patient outcomes and nurses’ ability to provide high quality care,” said Kutney-Lee. “This research offers a new angle to support the business case for pursuing Magnet status. We’re seeing how the process itself can boost safety for patients and stability for nursing staffs.”


Nearly all existing studies of Magnet hospital studies have relied on a cross-sectional design, limiting the understanding of the causal relationship between Magnet status and improved outcomes. “By contributing longitudinal evidence where there had been little of it, this study can give hospital leaders a different perspective on the potential for improvement,” Aiken said. “Becoming a Magnet hospital is a significant undertaking. The message is that it’s an investment that’s well worth it.”


The RWJF Initiative on the Future of Nursing, rooted in the recommendations of the landmark Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health, complements the Future of Nursing: Campaign for Action, a collaboration between RWJF and AARP focused on transforming health care through nursing. Through the Initiative, RWJF supports the report’s research agenda and implements recommendations in the areas of nurse training, education, professional leadership, and workforce policy.

About New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science with major in Nursing, a Master of Science and Post-Master’s Certificate Programs, a Doctor of Nursing Practice degree and a Doctor of Philosophy in Research Theory and Development. For more information, visit


The Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing is a research and research training enterprise focusing on the outcomes of health care and health workforce policy. Established in 1989, the Center is a unique community within the School of Nursing drawing together faculty, students, and pre- and post-doctoral fellows from nursing, sociology, demography, medicine, management, economics, and other related disciplines. With collaborators from around the world, Center researchers study health system reorganization and policy changes and aim to produce research evidence to improve the quality of health care.

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