A groundbreaking international intervention co- led by the University of Pennsylvania School of Nursing 's Center for Health Outcomes and Policy Research (CHOPR) and the KU Leuven Institute of Healthcare Policy in Belgium shows that redesigning hospital work environments with the Magnet Model® measurably improves nurse and physician wellbeing and strengthens patient safety.
Published in Medical Care , the study evaluated Magnet4Europe, the most significant organizational hospital intervention of its kind. Over two years, 56 hospitals in Belgium, England, Germany, Ireland, Norway, and Sweden partnered with 65 U.S. Magnet hospitals, including all six Penn Medicine hospitals, to adapt and implement the Magnet framework for workplace excellence.
Hospitals that achieved high levels of Magnet implementation saw striking results:
- 6.3 percentage-point drop in nurse burnout
- 7.6 percentage-point drop in nurses' intent to leave
- 6.4 percentage-point drop in unfavorable care-quality ratings
- 3.7 percentage-point drop in unfavorable patient-safety ratings
The average European hospital with the help of a U.S. Magnet twinning partner was able to fully enculturate 50 percent of Magnet features within two years. Each 10 percent gain in Magnet adoption translated into a 2.7 percentage point drop in nurses planning to leave, thus resulting in a significant decline in intended leavers in the average participating hospital. These findings show that improving hospital work environments and culture, not expecting nurses to tough it out, holds promise for significantly improving nurse retention. "This is a playbook for every hospital leader who wants to retain staff and keep patients safe," said Linda H. Aiken, PhD, RN, FAAN, FRCN , senior author and CHOPR founding director. "Magnet4Europe shows that healthier workplaces and safer care are within reach and within a leader's control."
Launched in early 2020 as COVID-19 swept the globe, Magnet4Europe sustained momentum through virtual learning collaboratives and hospital to hospital mentoring, showing that deep culture change is possible even under extreme strain.
"Clinician burnout is not inevitable," said Professor Walter Sermeus , co-author and co-director of Magnet4Europe based at KU Leuven in Belgium. "That hospitals achieved these results during a global pandemic shows that improving hospital work environments by empowering clinicians, strengthening leadership, and using evidence-based practice can reduce turnover and improve patient outcomes."
About Magnet4Europe
Magnet4Europe is a collaboration of Penn Nursing and KU Leuven (Belgium), in conjunction with top European universities, funded by the European Union's Horizon 2020 program (GA 848031) and the U.S. National Institute of Nursing Research, National Institutes of Health (NIH). The Magnet4Europe Network of European and U.S. Magnet hospitals continues to thrive and expand beyond its initial funding, underscoring its enduring value and international impact. [ www.magnet4europe.eu ]
About the University of Pennsylvania School of Nursing
The University of Pennsylvania School of Nursing (Penn Nursing) is one of the world's leading nursing schools. It has been ranked the #1 nursing school in the U.S. by QS University for a decade. Our Bachelor of Science in Nursing (BSN) is among the top-ranked programs in the nation, according to the 2026 U.S. News & World Report's Best Colleges rankings. Penn Nursing also consistently earns high rankings in U.S. News & World Report's annual list of best graduate schools and is a top recipient of National Institutes of Health (NIH) funding for nursing research. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice. Follow Penn Nursing on: Facebook , LinkedIn , YouTube , & Instagram .
About the Center for Health Outcomes and Policy Research
The Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing is dedicated to building the actionable evidence base needed to advance effective policy, practice, and health system reforms that improve health outcomes, cultivate clinician well-being, and promote health equity across communities.
