Penn Medicine nurses: ‘We’re Magnet because of what we do’

Excited chatter filled Pennsylvania Hospital’s Zubrow Auditorium one morning earlier this spring, as nursing and executive leaders awaited a call from the chair of the American Nurses Credentialing Center Commission on Magnet Recognition.

The room fell silent, then erupted in cheers and applause at the news: “The Commission on Magnet Recognition has unanimously voted to credential Pennsylvania Hospital as a Magnet organization.”

It was the hospital’s third Magnet designation, the most prestigious recognition of nursing excellence, bestowed on fewer than 10 percent of U.S. hospitals, and only 621 hospitals worldwide.

And it was a proud moment of recognition for the nursing staff at the nation’s first hospital, which takes pride in its historical roots and its centuries of innovation, through today, especially in the neurosciences, orthopaedics, obstetrics, and behavioral health.

“This was a true team effort, not just for everyone in this room, but all of our teams outside of it, who are outstanding in everything that they do,” Pennsylvania Hospital Chief Nursing Officer Melissa Zak, DNP, MBA, RN, proudly told the group gathered that day.

Not long after, in the Medical Alumni Hall at the Hospital of the University of Pennsylvania (HUP), the same commissioner called: The hospital had received its fifth consecutive Magnet designation, a distinction given to approximately 1 percent of hospitals. That renewal signified 20 years of sustained excellence, demonstrated through patient experience, patient outcomes, and nurses’ perception of their work environment, at Penn Medicine’s flagship academic hospital, the clinical home to many of Penn’s most famous medical breakthroughs such as CAR T cell therapy.

Penn Medicine Doylestown Hospital, the health system’s newest entity, is just beginning on its path to Magnet. All six of Penn’s other acute-care hospitals have been Magnet-certified multiple times:

• In March, five-time Magnet-designated Lancaster General Hospital submitted its application materials in hopes of receiving a sixth designation later this year
• Penn Presbyterian Medical Center is getting ready to submit its application for a fourth
• Princeton Health is working on the document for its fourth
• Chester County Hospital received its third Magnet designation in 2024

All of Penn Medicine’s hospitals share an investment in their nursing workforce and a system of shared decision-making with nurse leaders that allows those on the front lines to drive patient-care improvements, said Jim Ballinghoff, DNP, MBA, RN, chief nurse executive for the University of Pennsylvania Health System.

“Every one of them should be celebrated at the highest level for that performance,” Ballinghoff said. “It's about creating an environment where nurses thrive. That’s how you get these outcomes. We invest in our environment. We invest in our nursing workforce. We invest in the structures that all support this recipe.”

For a hospital to even be considered for Magnet, it must show that it has outperformed national benchmarks for a sustained period, across inpatient and outpatient settings, in several areas that nurses can impact.

HUP outperformed the benchmarks for arrival-to-treatment time for stroke patients and for patient satisfaction rates for care coordination, patient education, and patient safety, among other indicators. Penn Medicine hospitals regularly outperform national averages for nurse certification rates, the percentage of nurses with a bachelor’s degree in nursing, and nurse satisfaction results.

While each hospital is unique, those outcomes result from a system-wide culture that recognizes nurses’ contributions to patient outcomes and work culture, said Jessie Reich, PhD, RN, ANP-BC, director of Patient Experience and Magnet Programs at HUP.

The Magnet application is a feat in itself: a four-year process that involves collecting reams of data and research studies demonstrating evidence of nursing excellence—before applications went digital, they measured 15 inches thick—as well as a multi-day site visit by appraisers in which they speak with hundreds of nurses.

“The document underscores the quality of care provided by nurses collectively and underscores the power of a strong and talented nursing workforce,” Reich said.

Each application must include over 100 detailed, evidence-backed examples of transformational leadership, quality improvement, and other components of nursing excellence, often drawing from each hospital’s particular unique strengths or roles serving its patient communities.

For example, Lancaster General Hospital’s recent submission documented how Associate Chief Nursing Officer Alyssa Livengood Waite, MHA, MSN, RN, spent over a year advocating for a bill in the state legislature directing insurance coverage of pasteurized donor breast milk for medically fragile infants. A bill was ultimately passed in 2023, expanding the number of health conditions eligible for Medicaid-covered donor breast milk.

Lancaster General Hospital shared the story to demonstrate how one of its nursing leaders advocated for a community health need outside the hospital’s walls. While the hospital provides donor breast milk to any newborn that needs it, “the legislation really needed to have big supporters like us to help get it passed, since there are much smaller hospitals that cannot afford this cost, or even families who need the support in the outpatient environment,” Livengood Waite said.

When the commission awards a Magnet designation, it also highlights the hospital’s “exemplars”—programs, concepts, or practices seen in the submission or site visit that it considers worthy of being replicated globally.

At HUP, the 2025 appraisers highlighted—among many other initiatives—nursing and community engagement projects at HUP-Cedar, including the development of a shared governance model for this community-based facility in Southwest Philadelphia, and the opening of a new crisis response center. HUP was also recognized for several unique mentorship programs to develop nurses at all points in their careers, such as the Nurse Leader Ethics Fellowship, which began in 2022.

At Pennsylvania Hospital, this spring the Magnet appraisers called attention to the hospital’s Nursing Fellowship Program, launched in 2021 to give nurses exposure to leadership opportunities in non-clinical areas, such as nursing education and patient safety, allowing staff to advance their careers beyond the bedside.

The team also noted innovative initiatives at Pennsylvania Hospital like an inpatient behavioral health program called Project Prevention, which adapts the zones of regulation framework—typically used to help children manage their emotions—for adult patients. Using color-coded zones, such as red for anger, yellow for frustration or anxiety, and green for a calm or focused state, helps patients self-identify their feelings and allows providers to determine effective, therapeutic coping strategies.

A commitment to excellence

While the recognition is worthy of celebration, hospitals say their commitment to nursing excellence is a critical and ongoing component of the hospital’s culture, regardless of status.

“We don’t do this work for Magnet,” said Pennsylvania Hospital Magnet Program Manager Emma Cotter, MSN, RN, LSSGB. “We’re Magnet because of what we do.”