Health  Vol.5 No.8 , August 2013
Strategic management in the establishment of a magnet hospital: A nursing staff perspective

Magnet hospital certification has a reputation for being one solution to nurse recruitment and retention. It is a matter of priority for hospitals to identify and enhance the basic organizational social structures which promote the development and maintenance of magnetism. A total of 436 valid self-administered questionnaires were collected from nurses. Paired sample t-tests, importance-performance gap analysis andANO-VAwere applied. The aims of this study were to investigate the key factors in and the gaps between nurses’ perceptions and hospital performance in areas contributing to magnetism. The results showed that Salary structure, welfare, and manpower deployment were the key forces of magnetism influencing nursing practice. Public and private hospitals showed significant differences in manpower deployment and nurse-patient relationships. Nurses who rotated shifts were more dissatisfied with their hospital scheduling system. Therefore, personnel policies and program are the primary forces in the development of a magnet hospital. Considering the demand for flexible scheduling of nurses, providing a supportive work environment, and keeping pace with today’s changing health care environment could achieve better outcomes for nurses, patients, and hospitals. These findings provide a reference to help set priorities for the implementation and development of effective strategies with limited resources. Public hospitals should take the lead in promoting magnet hospitals and set up reasonable salary systems, nursing workforce standards, and administrative support in order to attract and effectively retain nurses.

Cite this paper: Yang, H. , Yu, C. and Wang, M. (2013) Strategic management in the establishment of a magnet hospital: A nursing staff perspective. Health, 5, 1318-1327. doi: 10.4236/health.2013.58179.

[1]   Gheith, N.A.-R. and Zakaria, A.M. (2012) Developing a guideline to enhance hospital magnetic features at pediatric hospital of Mansoura University. Journal of Applied Sciences Research, 8, 4478-4485.

[2]   UC Davis Medical Center (n.d.) Frequently asked questions (FAQs) about magnet.

[3]   Heede, K.V., Florquin, M., Bruyneel, L., Aiken, L.H., Diya, L., Lesaffre, E. and Sermeus, W. (2013) Effective strategies for nurse rentention in actue hospitals: A mixed method study. International Journal of Nursing Studies, 50, 185-194. doi:10.1016/j.ijnurstu.2011.12.001

[4]   Massachusetts General Hospital (n.d.) Magnet hospital re-designation visit.

[5]   Wolf, G.A. and Greenhouse, P.K. (2006) A road map for creating a magnet work environment. JONA, 36, 458-462. doi:10.1097/00005110-200610000-00006

[6]   ANCC (n.d.) Magnet recognition program model.

[7]   Drenkard, K. (2010) The business case for magnet. Journal of Nursing Administration, 40, 263-271. doi:10.1097/NNA.0b013e3181df0fd6

[8]   Kelly, L.A., McHugh, M.D. and Aiken, L.H. (2011) Nurse outcomes in magnet and non-magnet hospitals. The Journal of Nursing Administration, 41, 428-433. doi:10.1097/NNA.0b013e31822eddbc

[9]   Ricke-Kiely, T. and Robey-Williams, C. (2011) Leading the change reaction. Nursing Management, 42, 41-45.

[10]   Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J.A., Busse, R., Clarke, H. and Shamian, J. (2001) Nurses’ reports on hospital care in five countries. Health Affairs, 20, 43-53. doi:10.1377/hlthaff.20.3.43

[11]   Cameron, S.J., Horsburgh, M.E. and Armstrong-Stassen, M. (1994) Job satisfaction, propensity to leave and burnout in RNs and RNAs: A multivariate perspective. Canadian Journal of Nursing Administration, 7, 43-64.

[12]   Lakshmi, K.S., Ramachandran, T. and Boohene, D. (2012) Analysis of work life balance of female nurses in hospitals-comparative study between government and private hospital in Chennai, TN., India. International Journal of Trade, Economics and Finance, 3, 213-218.

[13]   Singer, P.A. (2000) Recent advances in medical ethics. British Medical Journal, 321, 282-285. doi:10.1136/bmj.321.7256.282

[14]   Laschbinger, H.K., Almost, J. and Tuer-Hodes, D. (2003) Workplace empowerment and magnet hospital characteristics. JONA, 33, 410-422. doi:10.1097/00005110-200307000-00011

[15]   Kanter, R. (1977) Men and women of the corporation. Basic Books, New York.

[16]   Kanter, R. (1993) Men and women of the corporation. 2nd Edition, Basic Books, New York.

[17]   Kanter, R. (1979) Power failure in management circuits. Harvard Business Review, 57, 65-75.

[18]   American Hospital Association (2010) Workforce 2015: Strategy trumps shortage. American Hospital Association, Washington, DC

[19]   Aiken, L.H. (2002) Superior outcomes for magnet hospitals: The evidence base. In: McClure, M.L. and Hinshaw, A.S., Eds., Magnet Hospitals Revisited: Attraction and Retention of Professional Nurses, American Nurses Publishing, Washington, DC, 61-82.

[20]   Lin, S.P., Chan, Y.H. and Tsai, M.C. (2009) A transformation function corresponding to IPA and gap Analysis. Total Quality Management & Business Excellence, 20, 829-846. doi:10.1080/14783360903128272

[21]   Lin, S.P. and Wang, M.J. (2012) Strategic management of behavioural change in type 2 diabetic patients. Public Health, 126, 18-24. doi:10.1016/j.puhe.2011.09.021

[22]   ANCC (n.d.) Forces of magnetism.

[23]   ANCC (n.d.) Nurse opinion questionnaire.

[24]   Frazier, S.C. (2003) Magnet home care agencies. Home Healthcare Nurse, 21, 603-610. doi:10.1097/00004045-200309000-00010

[25]   Aiken, L.H. and Poghosyan, L. (2009) Evaluation of “magnet journey to nursing excellence program” in Russia and Armenia. Journal of Nursing Scholarship, 41, 166-174. doi:10.1111/j.1547-5069.2009.01268.x

[26]   Ma, C.-C., Hwang, P.-W. and Alexander, J.W. (2010) Taiwanese nurses’ cognition and attitudes towards the Magnet Hospitals Recognition Programme. International Nursing Review, 57, 78-84. doi:10.1111/j.1466-7657.2009.00746.x

[27]   Sleutel, M.R. (2000) Climate, culture, context, or work environment? Organizational factors that influence nursing practice. Journal of Nursing Administration, 30, 53-58. doi:10.1097/00005110-200002000-00002

[28]   Bahalkani, H.A., Kumar, R., Lakho, A.R., Mahar, B., Mazhar, S.B. and Majeed, A. (2011) Job satisfaction in nurses working in tertiary level health care settings of Islamabad, Pakistan. Journal of Ayub Medical College Abbottabad, 23, 130-133.

[29]   Maryyan, M.T. (2005) Nurse job satisfaction and retention: Comparing public to private hospitals in Jordan. Journal of Nursing Management, 13, 40-50. doi:10.1111/j.1365-2834.2004.00453.x

[30]   Pillay, R. (2009) Work satisfaction of professional nurses in South Africa: A comparative analysis of the public and private sectors. Human Resources for Health, 7, 1-10. doi:10.1186/1478-4491-7-15

[31]   Demerouti, E., Bakker, A., Nachreiner, F. and Schaufeli, W.B. (2000) A model of burnout and life satisfaction amongst nurses. Journal of Advanced Nursing, 32, 454-464. doi:10.1046/j.1365-2648.2000.01496.x

[32]   Baxter, V. (2002) Nurses’ perception of their role and skills in a medium secure unit. British Journal of Nursing, 11, 1312-1321.

[33]   Takase, M., Maude, P. and Manias, E. (2005) Explaining nurses’ work behaviour from their perception of the environment and work values. International Journal of Nursing, 42, 889-898. doi:10.1016/j.ijnurstu.2004.12.008

[34]   Nabirye, R.C., Brown, K.C., Pryor, E.R. and Maples, E.H. (2011) Occupational stress, job satisfaction and job performance among hospital nurses in Kampala, Uganda. Journal of Nursing Management, 19, 760-768. doi:10.1111/j.1365-2834.2011.01240.x

[35]   Clifford, P.G. (1992) The myth of empowerment. Nursing Administration Quarterly, 16, 1-5. doi:10.1097/00006216-199201630-00003

[36]   Lephalala, R.P. (2006) Factors influencing nursing turnover in selected private hospitals in England. Master’s Thesis, University of South Africa, Pretoria.

[37]   Chen, Y.-M. and Johantgen, M.E. (2010) Magnet hospital attributes in European hospitals: A multilevel model of job satisfaction. International Journal of Nursing Studies, 47, 1001-1012. doi:10.1016/j.ijnurstu.2009.12.016

[38]   Wang, S.H., Sermsri, S., Sirisook, V. and Sawangdee, Y. (2003). Job satisfaction of staff nurses and their perception on head nurses leadership: A study in Sakaeo provincial hospital. Thailand Journal of Public Health and Development, 11, 88-100.

[39]   Ruggiero, J.S. and Pezzino, J.M. (2006) Nurses’ perceptions of the advantages and disadvantages of their shift and work schedules. Journal of Nursing Administration, 36, 450-453. doi:10.1097/00005110-200610000-00004

[40]   Barton, J. and Folkard, S. (1991) The response of day and night nurses to their work schedules. Journal of Occupational Psychology, 64, 207-218. doi:10.1111/j.2044-8325.1991.tb00555.x

[41]   Krausz, M., Sagie, A. and Bidermann, Y. (2000) Actual and preferred work schedules and scheduling control as determinants of job-related attitudes. Journal of Vocational Behavior, 56, 1-11. doi:10.1006/jvbe.1999.1688

[42]   Tzeng, H.-M. (2006) Model testing on the crisis interventions and actions to prevent medical disputes: A Taiwanese nursing perspective. Journal of Clinical Nursing, 15, 554-564. doi:10.1111/j.1365-2702.2006.01365.x

[43]   Kramer, M., Maguire, P. and Brewer, B.B. (2011) Clinical nurses in magnet hospitals confirm productive, healthy unit work environments. Journal of Nursing Management, 19, 5-17. doi:10.1111/j.1365-2834.2010.01211.x

[44]   Lowe, G.S., Schellenberg, G. and Shannon, H.S. (2003) Correlates of employees’ perceptions of a healthy work environment. American Journal of Health Promotion, 17, pp. 390-399. doi:10.4278/0890-1171-17.6.390

[45]   Schmalenberg, C. and Kramer, M. (2008) Essentials of a productive nurse work environment. Nursing Research, 57, 2-13. doi:10.1097/01.NNR.0000280657.04008.2a

[46]   Shattell, M. (2004). Nurse-patient interaction: A review of the literature. Journal of Clinical, 13, 714-722.

[47]   Triolo, P.K. (2008) Student Nurse Pathway.

[48]   Cook, L. (2005) Inviting teaching behavious of clinical faculty and nursing students’ anxiety. Journal of Nursing Education, 44, 156-161.

[49]   Smith, C.S., Swain, A. and Penprase, B. (2011) Congruence of perceived effective clinical teaching characteristics between students and preceptors of nurse anesthesia programs. Journal of the American Association of Nurse Anesthetists, 79, 62-68.

[50]   Huukkala, K. (2010) The professional know-how of a nurse working in an internal medicine ward. Master’s Thesis, University of Turku, Turku.

[51]   Watts, M.D. (2010) Certification and clinical ladder as the impetus for professional development. Critical Care Nuring Quarterly, 33, 52-59.

[52]   Miracle, V.A. (2007) Thinking about certification. Dimensions of Critical Care Nursing, 26, 72-75. doi:10.1097/00003465-200703000-00008

[53]   Riley, J.K., Roldand, D.H., James, D. and Norton, H.J. (2009) Clinical ladder: Nurses’ perceptions and satisfiers. Journal of Nursing Administration, 39, 182-188. doi:10.1097/NNA.0b013e31819c9cc0