title: Changes in patient and nurse outcomes associated with magnet hospital recognition.
abstract: BACKGROUND
  Research has documented an association between Magnet hospitals and better outcomes for nurses and patients. However, little longitudinal evidence exists to support a causal link between Magnet recognition and outcomes.
  
  
  OBJECTIVE
  To compare changes over time in surgical patient outcomes, nurse-reported quality, and nurse outcomes in a sample of hospitals that attained Magnet recognition between 1999 and 2007 with hospitals that remained non-Magnet.
  
  
  METHODS
  Retrospective, 2-stage panel design using 4 secondary data sources.
  
  
  METHODS
  One hundred thirty-six Pennsylvania hospitals (11 emerging Magnets and 125 non-Magnets).
  
  
  METHODS
  American Nurses Credentialing Center Magnet recognition; risk-adjusted rates of surgical 30-day mortality and failure-to-rescue, nurse-reported quality measures, and nurse outcomes; the Practice Environment Scale of the Nursing Work Index.
  
  
  METHODS
  Fixed-effects difference models were used to compare changes in outcomes between emerging Magnet hospitals and hospitals that remained non-Magnet.
  
  
  RESULTS
  Emerging Magnet hospitals demonstrated markedly greater improvements in their work environments than other hospitals. On average, the changes in 30-day surgical mortality and failure-to-rescue rates over the study period were more pronounced in emerging Magnet hospitals than in non-Magnet hospitals, by 2.4 fewer deaths per 1000 patients (P<0.01) and 6.1 fewer deaths per 1000 patients (P=0.02), respectively. Similar differences in the changes for emerging Magnet hospitals and non-Magnet hospitals were observed in nurse-reported quality of care and nurse outcomes.
  
  
  CONCLUSIONS
  In general, Magnet recognition is associated with significant improvements over time in the quality of the work environment, and in patient and nurse outcomes that exceed those of non-Magnet hospitals.
authors.affiliation: *Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA †New York University College of Nursing, New York, NY ‡University of Florida College of Nursing, Gainesville, FL §Massachusetts General Hospital Institute of Health Professions, Boston, MA.
authors.forename: Ann
authors.initials: A
authors.lastname: Kutney-Lee
authors.forename: Amy Witkoski
authors.initials: AW
authors.lastname: Stimpfel
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Sloane
authors.forename: Jeannie P
authors.initials: JP
authors.lastname: Cimiotti
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Quinn
authors.forename: Linda H
authors.initials: LH
authors.lastname: Aiken
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000401:mortality*; D017132:Workplace