Each year, the U.S. News & World Report Best Hospitals Honor Roll gives healthcare leaders a chance to look closely at what distinguishes the nation’s strongest hospitals. This year, one common thread is impossible to miss: Every hospital on the 2026-2027 Honor Roll is recognized through the American Nurses Credentialing Center’s Magnet Recognition Program.
Only 10.6% of U.S. hospitals are Magnet recognized. Among the 20 hospitals at the top of this year’s Honor Roll, the figure is 100%.
Magnet recognition alone does not explain a hospital’s performance. Healthcare is far too complex for any single designation to do that. But this pattern deserves attention, especially as U.S. News places greater emphasis on risk-adjusted outcomes. When every hospital at the top shares an independently validated commitment to nursing excellence, leaders should ask what that tells us.
I believe the answer begins with a simple truth: Excellent care is achievable when nurses have what they need to do their best work. Throughout my career, from direct care nursing to executive leadership roles, I have seen how the environment around nurses directly shapes the care patients receive and the likelihood nurses can flourish in these settings.
Nurses shape what patients experience
A patient may come to a hospital because of a renowned specialist or an advanced treatment. But from admission through recovery, it is most often a nurse who directly shapes a patient and family’s experience. Nurses notice when something has changed, help families understand what comes next, and make sure critical information moves with the patient from one part of the system to another.
Much of the work that keeps patients safe happens quietly and continuously. A nurse’s expert judgment can be the difference between an early intervention and a crisis. Nursing is not a service layered onto care. Nursing is care.
That is why the environment in which nurses practice matters so much. When nurses have meaningful influence related to care delivery and professional practice, access to learning and development, and tools to integrate evidence to support clinical outcomes, they can act earlier and improve the systems around them. Senior organizational leaders and nurse executives jointly share a responsibility to advocate for essential investments to enable such systems. Magnet provides a rigorous framework and peer review process – an expectation – for building and sustaining those conditions.
A systematic review of 21 studies found that Magnet hospitals generally reported stronger nurse and patient outcomes than non-Magnet hospitals, along with safer work environments and more cost-effective care. The findings included lower levels of nurse burnout and turnover as well as reductions related to several measures of patient harm.
A longitudinal study of 136 Pennsylvania hospitals offers another important signal. Hospitals that attained Magnet recognition improved more than those that remained non-Magnet, including 2.4 fewer 30-day surgical deaths and 6.1 fewer failure-to-rescue deaths per 1,000 patients. Behind many of these numbers is a patient with a lower risk profile who is less likely to suffer death or harm.
A credential does not produce those results by itself. What matters are the organizational conditions behind it. The same conditions Magnet asks hospitals to build are the ones research consistently connects to safer, high-quality care.
The investment reaches the bedside
When leaders talk about investing in nursing, the conversation often starts with staffing. It should. Effective staffing is fundamental to patient care and healthy work environments. But it cannot be where the conversation ends.
Nurses also need leaders who have been taught and mentored to care for colleagues in front-line roles, meaningful opportunities to learn and grow, and the ability to govern their professional practice and be seen as full partners within interprofessional teams. Access to data is essential for nurses and team members to determine where care is improving and where patients remain at risk. Magnet brings these elements together and makes them visible across an organization.
Hospitals see the greatest value when this framework is woven into everyday decisions. The investment shows up when a nurse leader has time to prioritize relationship-centered practices that nurture meaningful connection and recognize contributions. It shows up when a direct care nurse raises a concern and guides a practical organizational response. And it shows up when teams use nationally benchmarked data to learn, adjust and improve.
Nursing excellence belongs in every executive conversation about organizational performance. Investments in nurses create value that reaches far beyond a single budget line. The return appears in stronger teams, greater retention, reductions in preventable harm and in the trust noted by patients and families as reflected in patient experience measures.
The changing nursing workforce makes this work even more important. Nurses entering practice today are caring for patients with extraordinary complexity. Early career nurses need experienced colleagues who can help them build confidence and clinical judgment. Those experienced nurses, in turn, need fulfilling environments and opportunities to shape the future of care.
Professional governance must meet nurses where they are. Participation may look different than it did a generation ago, but its purpose remains the same: Nurses must be able to influence the decisions that affect their patients and their practice. This is, after all, the social contract nurses seek as professionals.
The way healthcare organizations support that voice should continue to evolve. Nurses at every stage of their careers deserve an environment where they can learn, lead and provide excellent care.
A lesson for every healthcare leader
At the highest-performing hospitals in the country, nursing excellence is not incidental. It is a deliberate organizational commitment.
For boards and executive teams, this should prompt a straightforward question: Are we creating the conditions for nurses to do their best work, and how do we know?
America’s best hospitals understand that nursing excellence and the highest standards of patient care are inseparable. They do more than say nurses are essential. They build an environment that supports nurses to turn their knowledge, judgment and compassion into better care.
Over the past 30 years, Magnet hospitals have demonstrated the power of fusing modern science and therapeutic interventions with exceptional nursing practice environments. We have a great opportunity to spread and scale these lessons to improve health and healthcare through the power of nurses.
Dr. Wood is president of the American Nurses Credentialing Center Board of Directors and executive vice president, patient care operations, and system chief nursing executive of Boston Children’s Hospital.
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