What Is the Attraction of a Magnet Hospital?

February 7th, 2012


By , BSN, RN

As nurses, and even nursing students, most us are aware of the Magnet designation for hospitals. We know it is supposed to mean the hospital has a great nursing staff and they love working there and patients get great care. But what else does the Magnet designation stand for and why should it be important to us?

Let’s take a look.

Magnet Recognition Program

In 1983 the American Academy of Nursing (AAN) Task Force on Nursing Practice in Hospitals conducted a study to identify work environments that attracted and retained top nurses. Forty-one of 163 institutions examined possessed qualities that seemed to attract and retain nurses, and were therefore described as “magnet” hospitals. The 14 characteristics that distinguished these organizations from others are known to this day as the "Forces of Magnetism."

In 1990 the American Nurses Credentialing Center (ANCC) was incorporated as an independent nonprofit organization through which the American Nurses Association (ANA) offers credentialing programs and services. In December of that year the ANA Board of Directors approved a proposal for the Magnet Hospital Recognition Program for Excellence in Nursing Services, building upon the 1983 magnet hospital study conducted by the AAN.

In 1994 the University of Washington Medical Center, Seattle, WA, became the first ANCC Magnet-designated organization. Since then 390 more hospitals have earned Magnet recognition, including four foreign hospitals: one in Lebanon, one in Singapore, and two in Australia. In 1998 Magnet expanded to include long-term care facilities.

Hospitals that earn the Magnet designation meet the standards of the original 14 “Forces of Magnetism,” which in 2008 were grouped into five key components:

  1. Transformational Leadership – According to the ANCC, “It is relatively easy to lead people where they want to go; the transformational leader must lead people where they need to meet the demands of the future.” The intent of this component of Magnet is that healthcare institutions can no longer just try to solve problems, fix broken systems, and empower staff, but must actually transform the organizations to meet the future. This requires vision, influence, clinical knowledge, and a strong expertise relating to professional nursing practice.

    Transformational leadership incorporates forces numbers one and three, quality of nursing leadership and management style.

  2. Structural Empowerment – Solid structures and processes developed by leadership provide an environment where strong professional practice flourishes. It is an organization where the mission, vision, and values come to life to achieve the outcomes believed to be important for the organization. Strong relationships and partnerships are developed with all kinds of community organizations to improve patient outcomes. This is accomplished through the organization's strategic plan, structure, systems, policies, and programs.

    The forces represented include organizational structure (Force #2), personnel policies and programs (Force #4), community and the healthcare organization (Force #10), image of nursing (Force #12), and professional development (Force #14).

  3. Exemplary Professional Practice – This component entails a comprehensive understanding of the role of nursing; the application of that role with patients, families, communities, and the interdisciplinary team; and the application of new knowledge and evidence. The goal is more than the establishment of strong professional practice; it is what that professional practice can achieve.

    Professional models of care, consultation and resources, autonomy, nurses as teachers and interdisciplinary relationships, Forces five eight, nine, 11, and 13 are represented in this component.

  4. New Knowledge, Innovations, and Improvements – This is the nursing research component of Magnet. Healthcare organizations, which earn the Magnet designation, must show they are open to and are even developing new models of care, applying existing evidence, building new evidence, and making visible contributions to the science of nursing. Force number 7, quality improvement is represented here.
  5. Empirical Outcomes – The question the ANCC poses to organizations seeking Magnet status is not "What do you do?" or "How do you do it?" but rather, "What difference have you made?" Healthcare organizations are expected to become pioneers of the future and to demonstrate solutions to numerous problems inherent in the health care systems today. Outcomes need to be categorized in terms of clinical outcomes related to nursing; workforce outcomes; patient and consumer outcomes; and organizational outcomes. When possible, outcomes data that the organization already collects should be utilized. Quantitative benchmarks should be established. These outcomes will represent the "report card" of a Magnet-recognized organization.
  6. The final remaining “Force” represented here is quality of care, number six.

Why Pursue Magnet Designation

For healthcare organizations that choose to try and earn Magnet designation there is a lot of work involved. Commitments must be made by administration and management to put in the work necessary, the nursing staff must buy in to wanting to be designated as a Magnet hospital and be willing to put in the hours to achieve it. It will involve surveys and writing proposals and forming committees and collecting reams of evidence supporting why the ANCC should bestow the Magnet honor.

And, it ain’t cheap. Costs start racking up immediately; application costs, documentation review and appraisal fees can stretch up to $250,000 or more depending on the facility’s bed size and resources.

After all is said and done however, there are benefits to the expense of time, energy, and manpower. Magnet hospitals tend to attract and retain top talent, not just in nursing, but all areas of the organization’s business. Magnet hospitals have been shown to have increased levels of patient satisfaction, patient safety, and quality care. Magnet hospitals also report decreased mortality rates, decreased falls, and fewer pressure ulcers.

From the financial side of the business, while expenditures earning Magnet may be high, hospitals report returns in areas including: reduction in RN agency rates, decreased RN vacancy and turnover rates, reductions in staff needle sticks, and musculoskeletal and other injuries. And, it’s great for PR.

As a traveling nurse I have had the opportunity to work at a number of hospitals that have earned Magnet recognition. The nurses I have worked with usually seem pretty proud of the designation and one thing I have noticed is that retention thing is no joke.

From the biggest of the big, The University of Texas MD Anderson Cancer Center, to Dartmouth Hitchcock Medical Center in New Hampshire, to the smaller designees like Hunterdon Medical Center in Flemington, New Jersey, I have seen one thing they all have in common. I have worked with nurses who have proudly put in 30 years or more at their respective hospitals. I guess they knew a quality institution when they saw one. The Magnet designation just brings that to the public’s attention.

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