The influence of community health on hospitals attainment of Magnet designation: Implications for policy and practice

AIMS: To determine if there is an association between better County Health Rankings and the increased odds of a hospital gaining Magnet designation in subsequent years (2014-2019) compared with counties with lower rankings. BACKGROUND: The Magnet hospital model is recognized to have a great effect on nurses, patients and organizational outcomes. Although Magnet hospital designation is a well-established structural marker for nursing excellence, the effect of County Health Rankings and subsequent hospital achievement of Magnet status is unknown. DESIGN: A descriptive, cross-sectional quantitative approach was adopted for this study. METHODS: Data were derived from 2010 to 2019 U.S. County Health Rankings, American Hospital Association, and American Nursing Credentialing Center databases. Logistic regression models were utilized to determine associations between county rankings for health behaviours, clinical care, social and economic factors, physical environment and counties with a new Magnet hospital after 2014. RESULTS: Counties with the worst rankings for clinical care and socio-economic status had reduced odds of obtaining a Magnet hospital designation compared with best-ranking counties. While middle-ranking counties for the physical environment ranking had increased odds of having Magnet designation compared with best-ranking counties. Additionally, having an increased percent of government non-federal hospital or a higher percentage of critical access hospitals in the county reduced the odds of having a Magnet-designated facility after 2014. CONCLUSION: The findings underscore the important associations between Magnet-designated facilities' location and the health of its surrounding counties. This study is the first to examine the relationship between County Health Rankings and a hospital's likelihood of obtaining Magnet status and points to the need for future research to explore outcomes of care previously identified as improved in Magnet-designated hospitals. IMPLICATIONS: Recognizing the benefits of Magnet facilities, it is important for health care leaders and policy makers to seek opportunities to promote centres of excellence in higher need communities through policy and financial intervention.