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Association of Magnet Nursing Status With Hospital Performance on Nationwide Quality Metrics

Boylan, Matthew R.; Suchman, Kelly I.; Korolikova, Helen; Slover, James D.; Bosco, Joseph A. III

The Journal for Healthcare Quality (JHQ): July/August 2019 - Volume 41 - Issue 4 - p 189–194
doi: 10.1097/JHQ.0000000000000202
Original Article

Introduction: Magnet Recognition is the highest distinction a healthcare organization can receive for excellence in nursing. Although Magnet status is generally associated with superior clinical outcomes and patient satisfaction, its association with performance on nationwide quality metrics is currently unknown.

Methods: Within a propensity score–matched cohort, we compared performance on the Hospital-Acquired Condition Reduction Program (HACRP), Hospital Value-Based Purchasing (VBP), and Hospital Readmissions Reduction Program (RRP) initiatives.

Results: The mean HACRP total performance score was inferior at Magnet versus non-Magnet hospitals (p < .001), and HACRP penalties were more likely to be levied against Magnet hospitals (p = .003). There was no significant difference according to Magnet status for VBP penalties after correcting for multiple comparisons (p = .049). There were no significant difference in RRP penalties according to Magnet status (p = .999).

Conclusions: Magnet hospitals performed worse on a number of hospitalwide quality metrics tied to reimbursement by the Centers for Medicare and Medicaid Service. Although Magnet hospitals are known for superior nursing care and organizational support for safety and quality improvement, this is not captured within these composite measures of quality, which can be influenced at many levels of care. These data underscore the need for comprehensive quality improvement across multiple domains of care outside of nursing.

Level of Evidence: Level III, retrospective study.

For more information on this article, contact Matthew R. Boylan at

J. D. Slover, conflicts of interest that are unrelated to this project include financial support from Biomet and board positions with the American Association of Hip and Knee Surgeons and Recent Advances in Arthroplasty. J. A. Bosco, conflicts of interest that are unrelated to this project include financial support from Medtronic, Genovel, Labrador Healthcare, Pacira, and Surgical Directions Consulting as well as board positions with the Hospital for Joint Diseases, Journal of Bone and Joint Surgery—American, and the Orthopaedic Learning Center. The remaining authors declare no conflicts of interest.

© 2019 National Association for Healthcare Quality
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