C.J. Goode and others have published an article in the Journal of Nursing Administration entitled, “Comparison of patient outcomes in Magnet® and non-Magnet hospitals.” You can view the abstract here. Let me give you the highlights:
Non-Magnet hospitals had better patient outcomes than Magnet hospitals. Magnet hospitals had slightly better outcomes for pressure ulcers, but infections, postoperative sepsis, and postoperative metabolic derangement outcomes were worse in Magnet hospitals.
What an indictment of a certification process that the American Nurses Credentialing Center describes as follows:
The Magnet Recognition Program® recognizes healthcare organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Consumers rely on Magnet designation as the ultimate credential for high quality nursing. Developed by the American Nurses Credentialing Center (ANCC), Magnet is the leading source of successful nursing practices and strategies worldwide.
What is the ANCC? It claims to be “the world’s largest and most prestigious nurse credentialing organization.” Its website explains:
The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), provides individuals and organizations throughout the nursing profession with the resources they need to achieve practice excellence.
For purposes of this post, let’s accept that and stay away from credentialing and professional advancement programs for individual nurses and focus on what it takes to receive Magnet® designation. Well, like other types of certification programs in other industries, your organization needs to meet an array of standards based on certain philosophical underpinnings, and you need to “pass” a review by independent surveyors.
You also need to pay a lot of money. There is an application fee, an appraisal fee, a documentation review fee, a site visit fee, and an extension fee if you want to postpone your site visit. In all, the process costs tens of thousands of dollars, paid to the ANCC, not to mention the costs incurred by the hospital on internal organizational matters.
So, here’s the question: With all that it takes to receive Magnet® status, and with all the assertions by the ANCC about the superior nature of Magnetized institutions, what peer-reviewed data exist that support the assertion that such hospitals do in fact deliver higher quality patient care than the non-Magnetic hospitals? We now have one such study that indicates the contrary.
Currently, there are 391 Magnet hospitals. As I look through the list of those from my own state of Massachusetts, I don’t see any that offer sufficient public, real-time data about clinical quality to prove the case of higher quality. And given the dearth of transparency with regard to clinical outcomes nationwide, it is hard to believe that one could do so in any other state.
I did a Google search on the topic of “quality of care at Magnet hospitals” and found very little. There was a 2010 thesis by Kelly Scott, a nursing student at the University of Kansas, entitled “Magnet Status: Implications for Quality of Patient Care,” which said:
In summary, this study did not find evidence to support the expectation that Magnet accreditation directly correlates to lower rates of hospital‐acquired infections.There was evidence to support existing research indicating that nursing workforce characteristics are better in Magnet hospitals. While Magnet accreditation remains the gold standard for nursing work environments, this status does not automatically lead to better patient outcomes.
And in the absence of real data, it seems that a hospital’s enthusiasm for the importance of this status can be transitory, at best:
Magnet hospital status was “the ultimate benchmark to measure the quality of care” for the University of Kentucky until it failed to get renewal of the designation.
A hospital official questioned its importance last week. “It is a recognition from a professional society,” said Dr. Richard Lofgren, chief clinical officer for UKHealthcare. “You can get recognition from a whole lot of professional societies.”
Uh oh, it sounds like a lot of revenue for the ANCC might be at risk unless peer-reviewed articles emerge that document real quality improvement results from this certification process.
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