A Magnet hospital is a healthcare facility that is identified as having exceptional nursing standards as well as a good work environment for nurses. Hospitals and other facilities apply for this status through the The American Nurses Credentialing Center's (ANCC) Magnet Recognition Program® (MRP). If they meet criteria in five areas and pass a site visit they're awarded the designation for four years. Though this is only one way of measuring a hospital's quality, Magnet facilities do tend to place highly in national and international rankings. There are a couple hundred such facilities in the US and a few in other countries.
Five Model Components
Each Magnet hospital has to meet specific standards in five areas called the Model Components. Within these areas, there are sub-categories called the 14 Forces of Magnetism. Practically speaking, these standards are intended to make facilities with a friendly, educated, relatively autonomous nursing force that provides very high standards of care. Magnet hospitals are also meant to be good places for nurses to work, where they're encouraged to communicate with the rest of the healthcare team, take part in decisions about patient care, and conduct research on new nursing methods. They ideally have a very low turnover of nurses and work with the community by hosting nursing or medical students.
The Model Components with their corresponding Forces of Magnetism are:
- Transformational Leadership:
- quality of nursing leadership
- management style
- Structural Empowerment:
- organizational structure
- personnel policies and programs
- community and healthcare organization
- image of nursing
- professional development
- Exemplary Professional Practice:
- professional models of care
- consultation and resources
- nurses as teachers
- interdisciplinary relationships
- New Knowledge, Innovation, and Improvements:
- quality improvement
- Empirical Quality Results:
- quality of care
Some studies show that a Magnet hospital is more likely to provide better patient care and a better work environment for nurses than most others, but others show that there's not actually that much difference between a Magnet hospital and other highly ranked hospitals. The MRP has also been criticized as being overly expensive, as each application and redesignation application costs tens of thousands of US Dollars (USD). Some nurses say that Magnet recognition is primarily a marketing technique at their hospitals, and that their workplace only really implements the required standards shortly before and after site visits. Magnet facilities do, however, tend to pay nurses more than other facilities, and Magnet status is generally viewed positively in the medical community.
Healthcare facilities can apply for Magnet status as either an organization or a system. Organizations include hospitals, rehabilitation centers, hospices, clinics, and similar facilities. Systems include two or more organizations; for instance, a system might include three hospitals that all share a governing board, or a hospital with an associated rehabilitation clinic. Both organizations and systems must fulfill specific criteria before they can apply.
Eligibility requirements for both organizations and systems are laid out in Nursing Administration: Scope and Standards of Practice, a publication of the American Nurses Association (ANA), the parent organization of the ANCC. Some of the requirements include having a system in place where nurses can confidentially give feedback without fear of reprisal, complying with all national laws, and having at least a certain ratio of nurses to patients. The MPR also requires applicants to make specific positions and fill them with people who meet certain requirements. For instance, a facility has to have a Chief Nursing Officer (CNO), who is ultimately responsible for all the nursing in the facility. He or she must have at least a master's degree in any subject as well as a bachelor's or doctoral degree specifically in nursing.
Eligible facilities submit an online application with a non-refundable fee and paperwork demonstrating their eligibility. Once the application is accepted, the MRP sends a team to conduct a site visit. During the visit, the team tours the facility to see if it complies with the five Model Components and talk to the nurses there. After the visit, the appraisers submit a confidential report to the Commission on Magnet Recognition, which then decides whether to give the facility the status or not.
Facilities that are awarded Magnet status must submit monitoring data after two years. If the data shows that they aren't continuously meeting Magnet standards, they can lose the designation. Those that lose their designation can apply again, but they may have to wait for a certain period of time, depending on why they lost it. All facilities, regardless of quality, must apply for redesignation every four years.