History of our Center

 In 1989, in response to the need for better information about crucial issues in health care surrounding nurse involvement, the Center for Health Outcomes and Policy Research was established. Since its inception a major focus of the Center's research has been exploring organizational effectiveness and aspects of health care that have the potential to impact patient outcomes. As a result of the Center's extensive work on the determinants of nurse and patient outcomes, the Center has been designated as the only NIH-supported core research center in nursing outcomes research.

Magnet Hospitals

The Center first began its research agenda by studying the outcomes of magnet hospitals: a designation given by the American Nurses’ Credentialing Center, an affiliate of the American Nurses Association, to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing. Magnet hospitals demonstrate a common set of organizational attributes - attributes that nurses collectively believe are important for the delivery of excellent care.  These attributes include an appropriate personnel mix to attain the best patient outcomes and staff work environment, as well as encouragement for advancing nursing practice. Through multiple studies, the Center demonstrated that magnet hospitals have lower Medicare mortality than a matched group of hospitals, as well as possess organizational traits that set them apart.  

Broadening the Scope

Building on the results of the magnet hospital studies, we designed a study to further evaluate organizational attributes and patient outcomes of high quality hospitals.  By studying hospitals in urban AIDS epicenters with dedicated AIDS units, we found that AIDS mortality was significantly lower in both magnet hospitals and dedicated AIDS units than in matched control hospitals. Importantly, we also found that patient satisfaction in magnet hospitals and dedicated AIDS units was significantly higher, due in part to the level of control that nurses were able to exercise over the practice setting.

International Reach

By broadening our focus to large, cross-national studies, we continued to study the impact of hospital organization on patient outcomes. Recently, we’ve researched hospitals in the US, Canada, England, Germany, Scotland, and New Zealand, collecting data from over 40,000 nurses practicing in 700 hospitals in the process. The results of our studies point to the importance of staffing and organizational climate on hospital outcomes across sites.

Multifactorial Focus

The role of nursing has not been studied in relation to the poorly understood link between volume and outcomes and we hope to fill this gap. We are also exploring the extent to which hospital nurse organization and staffing account for the relationship between diagnosis-and procedure-specific patient volumes and patient outcomes in hospital care in a large number of hospitals in Ontario and the US.  

Our research has expanded into many other areas, ranging from the effect of racial differences on hospital outcomes to the implementation of magnet hospital standards in hospitals in developing countries.