Lower mortality in magnet hospitals

Matthew D. McHugh, Lesly Kelly, Herbert L. Smith, Evan S. Wu, Jill M. Vanak, Linda H. Aiken

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Background: Although there is evidence that hospitals recognized for nursing excellence-Magnet hospitals-are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non- Magnets, and if so why. Objectives: To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non- Magnet hospitals, and to determine the most likely explanations. Method and Study Design: Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results: Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76-0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77-1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions: The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes.

Original languageEnglish (US)
Pages (from-to)S4-S10
JournalJournal of Nursing Administration
Volume43
Issue number10 SUPPL.
DOIs
StatePublished - Oct 1 2013

Keywords

  • Magnet hospitals
  • Nursing
  • organizational culture
  • quality of health care

ASJC Scopus subject areas

  • Leadership and Management

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    McHugh, M. D., Kelly, L., Smith, H. L., Wu, E. S., Vanak, J. M., & Aiken, L. H. (2013). Lower mortality in magnet hospitals. Journal of Nursing Administration, 43(10 SUPPL.), S4-S10. https://doi.org/10.1097/01.NNA.0000435145.39337.d5