Dissertation/Thesis Abstract

Magnet hospitals and patient outcomes
by Rosenberg, Marie-Claire, Ph.D., Dartmouth College, 2008, 159; 3397939
Abstract (Summary)

Objective. To evaluate the adoption of Magnet status by hospitals and whether adoption of Magnet status is associated with better nursing-sensitive outcomes.

Background. In the early 1980s, during a nursing shortage in the US, a group of hospitals was noted for their ability to consistently attract and retain a high-quality nursing workforce. The original research of these 41 hospitals became the foundation for the Magnet Recognition process. Each year since 1994, the American Nurses Credentialing Center (ANCC) evaluates tens of applicant US hospitals to determine whether they will become newly designated or retain Magnet status for another four years. Today, there are 293 healthcare organizations in 45 states, as well as one each in Australia and New Zealand, recognized for their excellence in nursing service.

Using the work of Donabedian (structure-process-outcomes) and the work of Rogers on the adoption of innovations, we explored two interrelated aims: (1) To investigate the relationship between hospital organizational characteristics related to performance and the adoption on Magnet status. (2) To investigate whether Magnet designated hospitals had better nursing-sensitive outcomes and overall organizational outcomes compared to non-Magnet hospitals.

Methods. In this thesis we used data from three main sources: (1) the American Hospital Association (AHA); (2) Medicare Claims data; and (3) data from the ANCC to establish Magnet status.

In study 1, we investigated which organizational characteristics were associated with hospitals Magnet status.

In study 2, a cross-sectional study of Magnet and non-Magnet hospitals, we used data aggregated for the years 2002 to 2004 to test the association between the exposure (receiving care in a Magnet hospital) and outcomes, using both nursing-sensitive outcomes and outcomes that reflect hospital performance as a whole.

Results. Magnet hospitals significantly differed, on the twelve organizational attributes tested, from non-Magnet hospitals. Hip fracture patients were less likely to experience a decubitus ulcer in Magnet hospitals. The nursing and general outcomes were not statistically significantly different in Magnet hospitals for AMI patients.

Conclusions. We identified the need to further investigate the nursing care processes. This information is pertinent to decision making and resource allocation both on the hospital and national levels.

Indexing (document details)
Advisor: Flood, Ann Barry
Commitee: Cole, Bernard F., Fennell, Mary L., Goodman, David C.
School: Dartmouth College
Department: Evaluative Clinical Sciences
School Location: United States -- New Hampshire
Source: DAI-B 71/04, Dissertation Abstracts International
Subjects: Nursing, Organizational behavior
Keywords: Magnet hospitals, Nursing-sensistive patient outcomes, Outcomes
Publication Number: 3397939
ISBN: 978-1-109-70356-6
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