Organizational confguration oF hospitals succeeding in attracting and
, William D’Hoore
& the NEXT-Study Group
Accepted for publication 28 July 2006
Sabine Stordeur MA PhD RN
William D’Hoore MD PhD
de Biostatistique et de
´rationnelles en Sante
Correspondence to Sabine Stordeur:
*This study is part of the European NEXT-
Study (Nurses’ Early Exit Study – http://
– H.M. Hasselhorn, B.H. Mu
(coordinators), P. Tackenberg, A.
¨mmerling, M. Simon, University of
Wuppertal; A. Bu
¨scher, University of Witten-
– W. D’Hoore, S.
´ catholique de Louvain;
L. Braeckman, P. Kiss, R. Verpraet, Ghent
– M. Laine, G.
¨m, Turku Regional Institute of
Occupational Health; France – M. Estryn-
Behar, O. Le Nezet, Assistance Publique
ˆpitaux de Paris;
– D. Gould,
St. Bartholomew School of Nursing and
Midwifery, City University, London;
D. Camerino, P. Conway, University of
– B. Van der Heijden,
E. van der Schoot, University of Twente;
– H. Oginska, J. Pokorski,
Jagiellonian University in Krakow; P.
Radkiewicz, M. Widerszal-Bazyl, Central
Institute for Labour Protection, Warsaw;
– A. Hanzlikova, M. Kovarova,
Department of Social Medicine, P.J. Safarik
– M. Josephson,
P. Lindberg, Karolinska Institute.
STORDEUR S., D’HOORE W. & THE NEXT-STUDY GROUP (2007)
tional con±guration of hospitals succeeding in attracting and retaining nurses*.
Journal of Advanced Nursing
Title. Organizational confguration oF hospitals succeeding in attracting and
This paper contrasts structural and managerial characteristics of low- and
high-turnover hospitals, and describes the organizational con±guration of attractive
In countries facing nurse shortages and turnover, some hospitals
succeed in recruiting and retaining nurses. In Magnet Hospitals, managerial prac-
tices and environmental characteristics increase nurses’ job satisfaction and their
commitment to the organization, which in turn decreases nurse turnover. Such an
approach suggests that organizations are best understood as clusters of intercon-
nected structures and practices, i.e. organizational con±gurations rather than enti-
ties whose components can be understood in isolation.
From a sample of 12 hospitals whose nurse turnover was studied for 1 year,
structural and organizational features of hospitals in the ±rst and fourth quartiles, i.e.
1%) vs. conventional (turnover
8%) were contrasted. A
questionnaire, including perceptions of health-related factors, job demands, stressors,
work schedules, organizational climate, and work adjustments antecedent to turn-
over, was received from 401 nurses working in attractive hospitals (response rate -