Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey

Autor: Ole Tjomsland, Kirsten Brubakk, Tonya Moen Hansen, Dag Hofoss, Martin Veel Svendsen, Paul Barach
Rok vydání: 2019
Předmět:
Male
Cross-sectional study
Myocardial Infarction
Nursing Staff
Hospital

Occupational Stress
0302 clinical medicine
Surveys and Questionnaires
patient safety
030212 general & internal medicine
Hospital Mortality
Child
Workplace
Stroke
Original Research
Aged
80 and over

Hip fracture
Norway
030503 health policy & services
Mortality rate
Workload
work environment
General Medicine
Middle Aged
Child
Preschool

Job satisfaction
Female
Health Services Research
0305 other medical science
patient outcome
Adult
medicine.medical_specialty
Adolescent
Job Satisfaction
safety climate
safety culture
03 medical and health sciences
Patient safety
Young Adult
medicine
Humans
Aged
Quality of Health Care
business.industry
Hip Fractures
Infant
Newborn

Infant
staff engagement
medicine.disease
Cross-Sectional Studies
Family medicine
Linear Models
business
Zdroj: BMJ Open
9:e031704
ISSN: 2044-6055
Popis: ObjectiveThis study examines the association between profession-specific work environments and the 7-day mortality of patients admitted to these units with acute myocardial infarction (AMI), stroke and hip fracture.DesignA cross-sectional study combining patient mortality data extracted from the South-Eastern Norway Health Region, and the work environment scores at the hospital ward levels. A case-mix adjustment model was developed for the comparison between hospital wards.SettingFifty-six patient wards in 20 hospitals administered by the South-Eastern Norway Regional Health Authority.ParticipantsIn total, 46 026 patients admitted to hospitals with AMI, stroke and hip fracture, and supported by 8800 survey responses from physicians, nurses and managers over a 3-year period (2010–2012).Primary and secondary outcome measuresThe primary outcome measures were the associations between the relative mortality rate for patients admitted with AMI, stroke and hip fractures and the profession-specific (ie, nurses, physicians, middle managers) mean scores on the 19 organisational factors in a validated cross sectional, staff survey conducted annually in Norway. The secondary outcome measures were the mean scores with SD on the organisational factors in the staff survey reported by each profession.ResultsThe Nurse workload (beta 0.019 (95% CI0.009–0.028)) and middle manager engagement (beta 0.024 (95% CI0.010–0.037)) levels were associated with a case-mix adjusted 7-day patient mortality rates. There was no significant association between physician work environment scores and patient mortality rates.Conclusion7-day mortality rates in hospital wards were negatively correlated with the nurse workload and manager engagement levels. A deeper understanding of the relationships between patient outcomes, organisational structure and their underlying cultural barriers is needed because they may provide a better understanding of the harm and death risks for patients due to organisational characteristics.
Databáze: OpenAIRE