Study Shows Lower Surgical Mortality in Hospitals with Best Nursing Care

Patients are often unaware that choosing the right hospital is very important to having a good outcome. A novel study published today in the journal JAMA Surgery showed that patients undergoing surgery at Magnet hospitals recognized for nursing excellence, and good nurse staffing, have better outcomes at the same or lower costs as other hospitals.

“We found that patients treated in hospitals with better nursing had significantly lower death rates after surgery,” says lead author Jeffrey H. Silber, MD, PhD, director of the Center for Outcomes Research at The Children’s Hospital of Philadelphia and Senior Fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania. The outcomes advantage for patients in Magnet hospitals was greater for all patients but especially for sicker and more complicated patients.

“Magnet designation for nursing excellence offers a way for patients to easily identify hospitals where they are more likely to have good outcomes following surgery,” says study co-author Matthew McHugh, PhD, JD, MPH, RN, associate director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

The authors used a novel approach to compare 25,076 matched pairs of Medicare patients having surgery in 328 hospitals. Pairs of patients had the exact same surgical procedure and were very similar in terms of age, sex, severity of illness, demographics, and chronic illnesses.

“A surprising finding was that better nurse staffing throughout the hospital does not have to be more costly. Indeed, we found that Magnet hospitals achieved lower mortality at the same or lower costs by admitting 40 percent fewer patients to intensive care units and shortening length of hospital stay,” says Linda Aiken, PhD, RN, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

This research collaboration consisted of authors from the Center for Outcomes Research at the Children’s Hospital of Philadelphia, Center for Health Outcomes and Policy Research at Penn’s School of Nursing, Penn’s Leonard Davis Institute of Health Economics and the Perelman School of Medicine at the University of Pennsylvania.

This research was funded by grant R01-HS018338 from the Agency for Healthcare Research and Quality and grant R01-NR014855 from the National Institute of Nursing Research.

Source: University of Pennsylvania School of Nursing