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

131 Citations (Scopus)

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)382-388
Number of pages7
JournalMedical Care
Volume51
Issue number5
DOIs
StatePublished - May 2013

Fingerprint

Magnets
Hospital Mortality
Nursing
Mortality
Nurses
Logistic Models
Odds Ratio
Confidence Intervals
Certification

Keywords

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

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

McHugh, M. D., Kelly, L., Smith, H. L., Wu, E. S., Vanak, J. M., & Aiken, L. H. (2013). Lower mortality in magnet hospitals. Medical Care, 51(5), 382-388. https://doi.org/10.1097/MLR.0b013e3182726cc5

Lower mortality in magnet hospitals. / McHugh, Matthew D.; Kelly, Lesly; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

In: Medical Care, Vol. 51, No. 5, 05.2013, p. 382-388.

Research output: Contribution to journalArticle

McHugh, MD, Kelly, L, Smith, HL, Wu, ES, Vanak, JM & Aiken, LH 2013, 'Lower mortality in magnet hospitals', Medical Care, vol. 51, no. 5, pp. 382-388. https://doi.org/10.1097/MLR.0b013e3182726cc5
McHugh MD, Kelly L, Smith HL, Wu ES, Vanak JM, Aiken LH. Lower mortality in magnet hospitals. Medical Care. 2013 May;51(5):382-388. https://doi.org/10.1097/MLR.0b013e3182726cc5
McHugh, Matthew D. ; Kelly, Lesly ; Smith, Herbert L. ; Wu, Evan S. ; Vanak, Jill M. ; Aiken, Linda H. / Lower mortality in magnet hospitals. In: Medical Care. 2013 ; Vol. 51, No. 5. pp. 382-388.
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