The economics of implementing Magnet^® designation: relevant parameters for a cost-benefit analysis in the German...

The U.S. Magnet^® model is an organizational intervention that aims to improve quality of care and patient outcomes by improving the hospital work environment for nurses. Its financial impact on German hospitals remains unclear. This study aimed to identify parameters for conducting a cost-benefit analysis for German hospitals seeking Magnet^® designation and assess availability of relevant data.

The hospital organizational perspective was adopted. A scoping review was conducted in January 2024 using Medline, CINAHL, Web of Science Social Sciences Citation Index and Cochrane Reviews to identify potential costs and cost-saving opportunities for hospitals implementing Magnet^®. Interviews with six key informants from nursing management from five German hospitals, participating in the Magnet4Europe study, were conducted in September and October 2024 to contextualize these findings for German hospitals. Market prices for each cost-saving potential were researched; further parameters to conduct a cost-benefit analysis were specified. The reporting of the economic components of the study adhered to the consolidated health economic evaluation reporting standards.

Potential costs include (i) fees of the American Nurses Credentialing Center, (ii) fees for benchmarking, (iii) expenses for professional development and staff and (iv) expenses for supporting resources, data management and innovations. In contrast to existing economic studies, German hospitals underlined potential expenses related to nurses' academization as part of nurses' professional development, and data management of nurse-sensitive indicators. Possible cost savings were identified from improvements in (i) nurse-sensitive indicators, (ii) nursing personnel indicators, and (iii) hospital performance. In contrast to existing studies, German hospitals stressed potential cost savings related to hospital performance. The possible cost-savings identified as relevant for the German hospitals were assigned market prices, although no values for injurious falls, pressure injuries category 2-4, and turnover costs were identified for the German healthcare system.

Potential key expenses and cost-saving opportunities for implementing Magnet^® designation in hospitals were identified and contextualized for German hospitals. Substantial data gaps currently impede a cost-benefit analysis and underscore critical implementation-relevant evidence gaps that require further research.