A culture of openness in hospitals is associated with lower hospital mortality, according to a study conducted among 137 acute trusts in England.
Hospital openness, defined as an environment in which staff freely speak up if they see something that may negatively affect a patient and feel free to question those with more authority, has already been linked with many positive outputs, such as better patient safety or better understanding of patients' care goals, but this is the first time that an association with mortality rates has been demonstrated.
The authors linked data on hospital mortality rates with hospital openness scores for the 137 acute trusts in the period 2012-14. They used the Summary Hospital-level Mortality Indicator (SHMI) as a measure of mortality and designed a standardised openness indicator that draws on staff surveys from the Picker Institute Europe's National Staff Survey.
The researchers found that fostering openness translates into lower mortality rates. When adjusted for hospital operating capacity, the results showed that a one-point increase in the standardised openness score was associated with a 6.48 per cent reduction in hospital mortality rates.
“These findings have important policy implications,” the authors said. “They offer empirical evidence to support further efforts to increase openness in the English hospital system, since doing so has improved health care quality.”