Institutional members access full text with Ovid®

Share this article on:

The diffusion of Magnet hospital recognition

Abraham, Jean; Jerome-D'Emilia, Bonnie; Begun, James W.

doi: 10.1097/HMR.0b013e318219cd27

Background: Magnet recognition is promoted by many in the practice community as the gold standard of nursing care quality. The Magnet hospital population has exploded in recent years, with about 8% of U.S. general hospitals now recognized.

Purpose: The purpose of this study was to identify the characteristics that distinguish Magnet-recognized hospitals from other hospitals within the framework of diffusion theory.

Methodology/Approach: We conceptualize Magnet recognition as an organizational innovation and Magnet-recognized hospitals as adopters of the innovation. We hypothesize that adoption is associated with selected characteristics of hospitals and their markets. The study population consists of the 3,657 general hospitals in the United States in 2008 located in metropolitan or micropolitan areas. We used logistic regression analysis to estimate the association of Magnet recognition with organizational and market characteristics.

Findings: Empirical results support hypotheses that adoption is positively associated with hospital complexity and specialization, as measured by teaching affiliation, and with hospital size, slack resources, and not-for-profit or public ownership (vs. for-profit). Adopters also are more likely to be located in markets that are experiencing population growth and are more likely to have competitor hospitals within the market that also have adopted Magnet status. A positive association of adoption with baccalaureate nursing school supply is contrary to the hypothesized relationship.

Practice Implications: Because of its rapid recent growth, consideration of Magnet program recognition should be on the strategic planning agenda of hospitals and hospital systems. Hospital administrators, particularly in smaller, for-profit hospitals, may expect more of their larger not-for-profit competitors, particularly teaching hospitals, to adopt Magnet recognition, increasing competition for baccalaureate-prepared registered nurses in the labor market.

Jean Abraham, PhD, is Assistant Professor, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis. E-mail:

Bonnie Jerome-D'Emilia, PhD, RN, MPH, is Assistant Professor of Nursing, Department of Nursing, Rutgers University-Camden, New Jersey. E-mail:

James W. Begun, PhD, is Hamilton Professor of Healthcare Management, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis. E-mail:

A previous version of this article was presented at the Annual Meeting of the Interdisciplinary Research Group on Nursing Issues, Academy Health, Boston, Massachusetts, June 26, 2010.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2011 Lippincott Williams & Wilkins, Inc.