Hospital Openness Leads to Lower Mortality Rates, Reports New Study

The researchers used the Summary Hospital-level Mortality Indicator (SHMI) as a measure of mortality.

According to a new study conducted among 137 acute trusts in England, the culture of openness in hospitals can be associated with lower hospital mortality. The openness of the hospital is defined as ‘an environment in which staff freely speaks up if they see something that may negatively affect a patient and feel free to question those with more authority. It has been linked to many positive outputs namely better patient safety, or a better understanding of patients’ care goals. However, this is the first time it has been associated with mortality rate.

The authors, Dr. Veronica Toffolutti from Bocconi University and London School of Hygiene & Tropical Medicine and David Stuckler from Bocconi University liked the data of hospital openness and mortality rate in England from period 2012-2014. The researchers used the Summary Hospital-level Mortality Indicator (SHMI) as a measure of mortality. They designed a standardized openness indicator that draws on staff surveys from the Picker Institute of Europe’s National Staff Survey. During this study, two positive findings were noticed.

First, fostering openness leads to lower mortality rates, and second, openness is increasing in England with the score increasing from 13.63 in 2012 to 16.49 in 2014. “The single component of our indicator that most affects mortality rates is good hospital procedures for reporting errors, near misses, and incidents,” said Dr. Toffolutti. She added further saying, “Moreover, as defensive medical practices could stymie openness, preventing the blame game that holds practitioners responsible for errors, in favor of institutional responsibility, could help the shift to a greater culture of openness.”

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