Magnet status hospitals: Better patient care, and a creative solution to the national nursing shortage

What is a magnet status hospital?

The Magnet Status Hospital program originated with the American Nurses Association's American National Nurses Credentialing Center (ANNC) in the early 1980s as a creative response to the crippling nursing shortage of the 1980s (McClure, Poulin, Sovie & Wandelt, 1983). ANCC developed the magnet status program to recognize hospitals that provide the highest-quality nursing care across a wide variety of measurement criteria, which are outlined in the American Nurses Association's Scope and Standards for Nurse Administrators, 2008 edition. The original intent of starting the Magnet Status program over 20 years ago was to help illustrate how hospitals could improve their nursing staff retention rates by facilitating a more professional and cohesive environment for nurses, therefore attracting better-quality nurses to join and remain on staff for the long term, and improving patient care in the process. That guiding philosophy continues in the ANNC's magnet status program to this day. The current ANNC magnet program also includes a program which magnet hospitals can use to share their best practices with one another (Gaguski, 2006).

Attaining magnet status is a highly competitive, complex, and extensive process that requires direct participation from all levels of a hospital's nursing staff. The credentialing process is extremely rigorous, takes several months, and a large proportion of hospitals that apply fail. Accordingly, being designated a magnet status hospital is quite rare and also quite an honor. To illustrate just how rare the status is, as of 2008, the ANNC only designated 263 American hospitals (out of 5,815) with magnet status, or less than 5% of all U.S. hospitals (Anderson, 2008).

The American Nurses' Association (ANA), which is also the ANNC's governing body, lists 14 characteristics that differentiate hospitals that attract and retain nurses (i.e., "magnet status" hospitals) from others:

• Quality of nursing leadership
• Organizational structure
• Management style
• Personnel policies and programs
• Professional models of care
• Quality improvement
• Consultation and resources
• Autonomy
• Community and the hospital
• Nurses as teachers
• Image of nursing
• Professional development (McClure & Hinshaw, 2002)

Notably, among the many rigorous criteria hospitals applying for magnet status must adhere to are higher levels of education—i.e., BSN degrees or above—for their staff nurses.

The American Nurses' Credentialing Center has issued the following list of benefits to both magnet status hospitals and their consumers. Magnet hospitals:

• Consistently outperform non-Magnet organizations
• Deliver better patient outcomes
• Experience increased time spent by staff at the bedside
• Have shorter lengths of stay
• Have lower mortality rates
• Have lower incidence of needlestick injuries
• Enjoy increased nurse retention and increased rates of job satisfaction
• Report higher patient satisfaction rates

Putting magnet status to work in Arizona and across the USA: Banner Health

Banner Health is one of the nation's largest nonprofit hospital administration companies. Based in Phoenix, Arizona, Banner Health manages 23 hospitals in seven U.S. states—Alaska, Arizona, California, Colorado, Nebraska, Nevada, and Wyoming. With more than 35,000 employees across its 22-hospital system serving more than 234,000 inpatients and 605,000 people in its emergency departments annually, Banner Health is a major contributor to the healthcare economy of the American West. Banner Health also enjoys strong ties with the University of Phoenix: Several of Banner's leading nursing staff also serve as University faculty, while a significant number of University of Phoenix Nursing graduates (BSN and above) have become Banner Health employees.

In addition to its sheer size and scope, Banner Health's Banner Good Samaritan Medical Center has also received national accolades for its patient safety programs, and has been ranked as one of "America's Best Hospitals" by U.S. News and World Report for nine years running. Not only that, several of its hospitals enjoy magnet status as conveyed by the ANNC. Colleen Hallberg, RN, MSN, FACHE and Chief Nursing Officer (CNO) of Banner Good Samaritan Medical Center, one of Banner's magnet status hospitals, describes how magnet status has impacted the hospital and its patients.

Banner Good Samaritan's nursing staff, Hallberg says, have been instrumental in helping to achieve magnet status. "We have a team of Magnet Ambassadors, along with a Magnet Coordinator who helps guide activity and make certain we are upholding the standards of being a magnet designated facility," says Hallberg. "We have used strategic planning as a regular activity to focus the Division of Nursing on key priorities that not only help meet Banner's mission, but also track well with being a magnet hospital."

Hallberg is also quick to point out that achieving magnet status has made an enormous impact on the quality of patient care at Banner Good Samaritan.

"Magnet status has definitely helped us maintain greater focus on achieving excellence in patient care delivery," says Hallberg. "The [magnet] standards are lofty and push us to achieve greater levels of measurable excellence."

ANNC's magnet status criteria generally require a hospital to have attained a much higher level of education and ongoing training of its nurses than the average hospital, and those higher standards are reflected in Banner Good Samaritan's hiring practices for nurses.

"Our criteria are well-defined for hiring," says Hallberg. "Our facility has many requirements for nurse education, including a variety of ‘academies' for nurses new to a service like critical care, the emergency department, or perioperative services. These academies, along with a new graduate residency program, help us with retention as well as the more obvious need to have a well-trained and prepared nurse."

Hallberg goes on to say that achieving magnet status has not only helped Banner Good Samaritan attract many new nursing graduates, but it has also led directly to improved patient outcomes and lower costs.

"I find that more and more nurse recruits are aware of magnet status hospitals and will seek one out," says Hallberg. "Costs have also improved for us as recruitment and retention have improved. A major change at my facility from a dependency on casual labor (i.e., traveling nurses) to nearly all core staffing [with permanent employees] not only saved expense, but also provided more continuity. [And] quality indicators have improved almost across the board."

When asked to sum up how she feels about being Chief Nursing Officer of a hospital enjoying the rare and prestigious magnet status designation, Hallberg sums it up this way: "It's inspiring," she says. "The outcomes, the achievement, and the sheer joy of holding this designation are a career high for many."

Sheila Bodell, MLS contributed research support to this article.

References

McClure M.L., Poulin M.A., Sovie M.D., & Wandelt M.A. (1983). Magnet hospitals: Attraction and retention of professional nurses. Kansas City, MO: American Nurses' Association.

Gaguski, M. (2006). Magnet status—what's the attraction? ONS News: Official Newsletter of the Oncology Nursing Society 21 (3) p. 2-5.

Anderson, H.J. (2008). Magnet hospitals rely on I.T. Healthdatamanagement.com, February 2008.

McClure M.L, & Hinshaw A.S. (Eds.) (2002). Magnet hospitals revisited: Attraction and retention of professional nurses. Washington, DC: American Nurses' Association.