title: Hospitals In 'Magnet' Program Show Better Patient Outcomes On Mortality Measures Compared To Non-'Magnet' Hospitals.
abstract: Hospital executives pursue external recognition to improve market share and demonstrate institutional commitment to quality of care. The Magnet Recognition Program of the American Nurses Credentialing Center identifies hospitals that epitomize nursing excellence, but it is not clear that receiving Magnet recognition improves patient outcomes. Using Medicare data on patients hospitalized for coronary artery bypass graft surgery, colectomy, or lower extremity bypass in 1998-2010, we compared rates of risk-adjusted thirty-day mortality and failure to rescue (death after a postoperative complication) between Magnet and non-Magnet hospitals matched on hospital characteristics. Surgical patients treated in Magnet hospitals, compared to those treated in non-Magnet hospitals, were 7.7 percent less likely to die within thirty days and 8.6 percent less likely to die after a postoperative complication. Across the thirteen-year study period, patient outcomes were significantly better in Magnet hospitals than in non-Magnet hospitals. However, outcomes did not improve for hospitals after they received Magnet recognition, which suggests that the Magnet program recognizes existing excellence and does not lead to additional improvements in surgical outcomes.
authors.affiliation: Christopher R. Friese (cfriese@umuch.edu) is an assistant professor in the School of Nursing at the University of Michigan, in Ann Arbor.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Friese
authors.affiliation: Rong Xia is a doctoral student in biostatistics in the School of Public Health at the University of Michigan.
authors.forename: Rong
authors.initials: R
authors.lastname: Xia
authors.affiliation: Amir Ghaferi is an assistant professor in the Department of Surgery and the Ross School of Business at the University of Michigan.
authors.forename: Amir
authors.initials: A
authors.lastname: Ghaferi
authors.affiliation: John D. Birkmeyer is executive vice president at Enterprise Support Services and chief academic officer at the Dartmouth-Hitchcock Medical Center, in Hanover, New Hampshire.
authors.forename: John D
authors.initials: JD
authors.lastname: Birkmeyer
authors.affiliation: Mousumi Banerjee is a research professor of biostatistics in the School of Public Health at the University of Michigan.
authors.forename: Mousumi
authors.initials: M
authors.lastname: Banerjee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000067248:Failure to Rescue, Health Care; D005260:Female; D017052:Hospital Mortality; D006761:Hospitals / Q000592:standards*; D006801:Humans; D008297:Male; D006278:Medicare; D009732:Nursing Care / Q000592:standards*; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000401:mortality; D014481:United States
keywords: Hospitals; Medicare; Nurses; Organization and Delivery of Care; Quality Of Care