How Magnet hospitals can promote nurse leadership and improve staff well-being

Magnet scheme being tested in England aims to attract and retain nurses, and enhance patient care

After a traumatic year at the forefront of the COVID-19 response, 14 hospitals in England are among those taking part in a Europe-wide project to improve nurses’ working environments and reduce their stress levels.

The four-year Magnet4Europe study will implement the principles of the Magnet programme – a US accreditation scheme that recognises excellence in nursing care.

What is ‘Magnet’ and where did it come from?

The Magnet Recognition Programme is accredited by the American Nurses Credentialing Center (ANCC) – the non-profit credentialing arm of the American Nurses Association (ANA).

In 1983, the American Academy of Nursing task force conducted a study to identify work environments that attracted and retained well-qualified nurses who promoted quality patient care.

Out of 163 institutions investigated, 41 possessed qualities that enabled greater capacity to attract and retain nurses, and were described as ‘magnet’ hospitals.

The characteristics that distinguished these organisations from others are known in the Magnet model as the ‘forces of magnetism’.

By the end of 1990, a proposal for the first Magnet Hospital Recognition Program for Excellence in Nursing Services was approved by the ANA.

What elements make up ‘magnetism’ – and how are they relevant to nursing?

The defining characteristics of magnetism are strong nurse leadership, flexible working, involving nurses in decision-making, an emphasis on continuing education, and adequate staffing levels.

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‘Characteristics include nurse leaders who are transformational, strategic, influential advocates who value the voice, knowledge and expertise of clinical nurses,’ says Magnet expert and consultant Mary Del Guidice.

‘Magnet organisations create structures and processes that support a culture of autonomy, professional growth, interprofessional collaboration, innovation and patient-centredness.’

Why is Magnet recognition so important?

Ms Del Guidice led Pennsylvania Hospital to its first Magnet designation during her time as chief nurse.

‘Achieving ANCC Magnet designation is the highest honour an organisation can achieve in recognition of nursing excellence and quality patient care,’ she explains.

Ms Del Guidice says achieving the Magnet designation requires a ‘demonstration of excellence’ through evidence including high levels of nurse satisfaction, patient satisfaction, quality and safety outcomes.

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‘Magnet designation also identifies organisations where leaders value nurse autonomy and decision-making,’ she adds.

‘It provides an environment that supports the advancement of the profession.’

Decades of research led by nurse academics such as Linda Aiken demonstrate that key differences between Magnet and non-Magnet organisations include less nurse burnout, lower nurse turnover rates and lower patient mortality rates.

How do organisations achieve Magnet status?

The process for achieving Magnet designation is described as ‘rigorous and lengthy’ by the ANCC.

It begins with the submission of an electronic application, followed by written documentation demonstrating qualitative and quantitative evidence regarding patient care and outcomes.

If scores from the written documentation fall within a range of excellence, and meet all the Magnet requirements, an on-site visit takes place for a thorough assessment.

Ms Del Guidice says: ‘During this stage, the appraisers spend several days at the organisation to clarify and validate the information in the document.

‘The appraiser then submits their recommendations to the Commission on Magnet Recognition.’

The Commission reviews the completed appraisal report and members vote to decide if Magnet recognition should be granted.

How long does it take an organisation to achieve Magnet status?

‘On average it takes three to five years to achieve Magnet designation,’ says Ms Del Guidice.

‘Accreditation lasts for four years, at which point the organisation must repeat the process to retain its designation.

‘After two years, the organisation is required to submit an interim report to demonstrate continued adherence to the requirements.’

Are there any Magnet hospitals in the UK or Europe?

There are 561 Magnet facilities, mainly based in the US. Nottingham University Hospitals NHS Foundation Trust is the only organisation in the UK that has so far achieved Magnet accreditation.

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The only other hospital in Europe that has achieved the designation is Antwerp University Hospital.

A four-year research project, known as the Magnet4Europe study, began in 2020.

Over the next few years, 60 hospitals in six countries – the UK, Ireland, Belgium, Germany, Sweden and Norway – will test how well Magnet principles work in Europe.

• RELATED: EU funds €4 million programme for hospitals to achieve Magnet status

The study will look at the effectiveness of redesigning hospital work environments based on Magnet principles, supported by an experienced Magnet partner, and whether this improves the well-being of the workforce, indicated by job satisfaction and levels of burnout, sickness absence and retention.

Is it only hospitals that can achieve Magnet accreditation?

Magnet designation is available to any healthcare organisation regardless of size, setting, or location.

Stephanie Jones-Berry is RCNi features editor