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Magnet4Europe Intervention to Improve Clinician and Patient Well-Being

A Quasi-Experimental Study of 56 Hospitals in 6 European Countries

Bibliographic Data

ID9102919
AuthorsLinda H Aiken (0000-0001-8004-3630, University of Pennsylvania, corresponding author), Walter Sermeus (0000-0002-5915-1845, KU Leuven, Leuven Institute for Healthcare Policy, Leuven, Belgium), Karen B Lasater (0000-0002-5834-1954, University of Pennsylvania, corresponding author), Ralf Busse (0000-0003-4961-9130, Berliner Hochschule für Technik), Reinhard Busse (Department of Health Care Management, Berlin University of Technology, Berlin, Germany), Martin Mckee (0000-0002-0121-9683, London School of Hygiene and Tropical Medicine, London, UK), Herbert Smith (Department of Sociology, University of Pennsylvania Population Studies Center, Philadelphia, PA), Jonathan Drennan (0000-0001-7365-4345, University College Dublin, School of Nursing, Midwifery and Health Systems, University College Dublin, Health Sciences Centre, Belfield, Dublin, Ireland), Claudia B Maier (0000-0002-7734-2258, Bielefeld University), Jane Ball (0000-0002-8655-2994, Royal College of Nursing, corresponding author), Simon Dello (KU Leuven, Leuven Institute for Healthcare Policy, Leuven, Belgium), Simon A G Dello (Rega Institute for Medical Research), Dorothea Kohnen (0000-0002-7220-1819, KU Leuven, Leuven Institute for Healthcare Policy, Leuven, Belgium), Rikard Lindqvist (0000-0002-1913-8523, Karolinska Institutet), Anners Lerdal (0000-0002-7144-5096, University of Oslo), Peter Griffiths (0000-0003-2439-2857, University of Southampton, Health Workforce and Systems Research Group, Southampton, UK), Wilmar B Schaufeli (0000-0002-6070-7150, Department of Psychology, KU Leuven, Research Unit Occupational and Organizational Psychology and Professional Learning, Leuven, Belgium and Utrecht University, Utrecht, The Netherlands), Hans De Witte (0000-0002-6691-517X, KU Leuven, Research Unit Occupational and Organizational Psychology and Professional Learning, KU Leuven, Belgium), Lars E Eriksson (0000-0001-5121-5325, Karolinska Institutet, corresponding author), Anne Marie Rafferty (0000-0003-1010-6581, Kings College, London, England, UK), Rafferty Am (King's College London), Julia Köppen (0000-0001-7941-641X, Department of Health Care Management, Berlin University of Technology, Berlin, Germany), Lisa Smeds Alenius (0000-0001-6927-1923, Karolinska Institutet), Matthew D McHugh (0000-0002-1263-0697, University of Pennsylvania, corresponding author)
Year2026
Volume64
Issue2
Pages50-58
Publication date2026-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002257
PMID41427777
OpenAlexW7116731582
LanguageEN
References cited24

BACKGROUND: Descriptive studies have documented high hospital nurse burnout and turnover but there are few, if any, large-scale evaluations of organizational interventions to improve clinician retention. The Magnet model is an organizational hospital intervention associated with better clinician and patient outcomes but there is insufficient evidence as to whether the Magnet model based on structural empowerment of clinicians results in better outcomes or rewards hospitals with good work environments, and whether the Magnet model can be implemented at scale outside the United States. OBJECTIVE: To evaluate whether Magnet4Europe-a multiyear organizational intervention of European hospitals-could be implemented and would result in improvements in nurse well-being, care quality, and patient safety. DESIGN: Quasi-experimental longitudinal evaluation of 56 European intervention hospitals in 6 countries. Hospital-level implementation of the intervention measured by changes (from baseline to follow-up) in 77 Magnet model intervention targets. Outcome measures (eg, nurse burnout, intent to leave, quality of care, patient safety) were derived from surveys of nurses (4546 nurses at baseline; 3171 at follow-up). FINDINGS: Hospitals that implemented intervention targets during the study period observed reductions in nurse burnout, nurses' intentions to leave their jobs, and unfavorable care quality. Each 10-percentage-point increase in intervention target implementation was associated with 2.7%-point reduction in nurses who intend to leave (β -2.66; 95% CI: -4.74, -0.58, P <0.05). Hospitals which implemented more than 25% of intervention targets observed 6.3%-point reduction in nurse burnout, 7.6%-point reduction in intent to leave, 6.4%-point reduction in unfavorable care quality, and 3.7%-point reduction in unfavorable patient safety. Improvements in hospital percentages of nurses reporting staffing adequacy were associated with reductions in burnout, intentions to leave, unfavorable care quality, and patient safety. CONCLUSION: Successful implementation of Magnet4Europe demonstrates promise for international adoption at scale of Magnet as an organizational intervention for improving clinician well-being, care quality, and patient safety

Intervention (counseling) · MEDLINE · Patient care · Patient satisfaction · Patient-centered care · Quality management · Scale (ratio) · Healthcare professionals’ stress and burnout · Nursing education and management · Workplace Violence and Bullying

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