Karen B Lasater1, Michael R Richards, Nikila B Dandapani, Lawton R Burns, Matthew D McHugh. 1. Karen B. Lasater, PhD, RN, is Postdoctoral Fellow, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia. E-mail: karenbl@upenn.edu. Michael R. Richards, MD, PhD, MPH, is Assistant Professor, Department of Health Policy, Vanderbilt University, Nashville, Tennessee. Nikila B. Dandapani, BA, is Research Assistant, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia. Lawton R. Burns, PhD, MBA, is Professor and Director, Wharton Center for Health Management and Economics, University of Pennsylvania, Philadelphia. Matthew D. McHugh, PhD, JD, RN, MPH, CRNP, FAAN, is Associate Professor and Associate Director, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia.
Abstract
BACKGROUND: Magnet hospitals are recognized for nursing excellence and high-value patient outcomes, yet little is known about which and when hospitals pursue Magnet recognition. Concurrently, hospital systems are becoming a more prominent feature of the U.S. health care landscape. PURPOSE: The aim of the study was to examine Magnet adoption among hospital systems over time. APPROACH: Using American Hospital Association surveys (1998-2012), we characterized the proportion of Magnet hospitals belonging to systems. We used hospital level fixed-effects regressions to capture changes in a given system hospital's Magnet status over time in relation to a variety of conditions, including prior Magnet adoption by system affiliates and nonaffiliates in local and geographically distant markets and whether these relationships varied by degree of system centralization. RESULTS: The proportion of Magnet hospitals belonging to a system is increasing. Prior Magnet adoption by a hospital within the local market was associated with an increased likelihood of a given system hospital becoming Magnet, but the effect was larger if there was prior adoption by affiliates (7.4% higher likelihood) versus nonaffiliates (2.7% higher likelihood). Prior adoption by affiliates and nonaffiliates in geographically distant markets had a lesser effect. Hospitals belonging to centralized systems were more reactive to Magnet adoption of nonaffiliate hospitals as compared with those in decentralized systems. CONCLUSIONS: Hospital systems take an organizational perspective toward Magnet adoption, whereby more system affiliates achieve Magnet recognition over time. PRACTICE IMPLICATIONS: The findings are relevant to health care and nursing administrators and policymakers interested in the diffusion of an empirically supported organizational innovation associated with quality outcomes, particularly in a time of increasing hospital consolidation and system expansion. We identify factors associated with Magnet adoption across system hospitals and demonstrate the importance of considering diffusion of organizational innovations in relation to system centralization. We suggest that decentralized system hospitals may be missing potential benefits of such organizational innovations.
BACKGROUND: Magnet hospitals are recognized for nursing excellence and high-value patient outcomes, yet little is known about which and when hospitals pursue Magnet recognition. Concurrently, hospital systems are becoming a more prominent feature of the U.S. health care landscape. PURPOSE: The aim of the study was to examine Magnet adoption among hospital systems over time. APPROACH: Using American Hospital Association surveys (1998-2012), we characterized the proportion of Magnet hospitals belonging to systems. We used hospital level fixed-effects regressions to capture changes in a given system hospital's Magnet status over time in relation to a variety of conditions, including prior Magnet adoption by system affiliates and nonaffiliates in local and geographically distant markets and whether these relationships varied by degree of system centralization. RESULTS: The proportion of Magnet hospitals belonging to a system is increasing. Prior Magnet adoption by a hospital within the local market was associated with an increased likelihood of a given system hospital becoming Magnet, but the effect was larger if there was prior adoption by affiliates (7.4% higher likelihood) versus nonaffiliates (2.7% higher likelihood). Prior adoption by affiliates and nonaffiliates in geographically distant markets had a lesser effect. Hospitals belonging to centralized systems were more reactive to Magnet adoption of nonaffiliate hospitals as compared with those in decentralized systems. CONCLUSIONS: Hospital systems take an organizational perspective toward Magnet adoption, whereby more system affiliates achieve Magnet recognition over time. PRACTICE IMPLICATIONS: The findings are relevant to health care and nursing administrators and policymakers interested in the diffusion of an empirically supported organizational innovation associated with quality outcomes, particularly in a time of increasing hospital consolidation and system expansion. We identify factors associated with Magnet adoption across system hospitals and demonstrate the importance of considering diffusion of organizational innovations in relation to system centralization. We suggest that decentralized system hospitals may be missing potential benefits of such organizational innovations.
Authors: Ann Kutney-Lee; Amy Witkoski Stimpfel; Douglas M Sloane; Jeannie P Cimiotti; Lisa W Quinn; Linda H Aiken Journal: Med Care Date: 2015-06 Impact factor: 2.983
Authors: Walter Sermeus; Linda H Aiken; Jane Ball; Jackie Bridges; Luk Bruyneel; Reinhard Busse; Hans De Witte; Simon Dello; Jonathan Drennan; Lars E Eriksson; Peter Griffiths; Dorothea Kohnen; Julia Köppen; Rikard Lindqvist; Claudia Bettina Maier; Matthew D McHugh; Martin McKee; Anne Marie Rafferty; Wilmar B Schaufeli; Douglas M Sloane; Lisa Smeds Alenius; Herbert Smith Journal: BMJ Open Date: 2022-07-28 Impact factor: 3.006