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

Objective This 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.Design A cross-sectional study combining patient mortality data extracted from the S...

Full description

Saved in:
Bibliographic Details
Main Authors: Martin Veel Svendsen, Tonya Moen Hansen, Kirsten Brubakk, Dag Hofoss, paul Barach, Ole Tjomsland
Format: Article
Language:English
Published: BMJ Publishing Group 2019-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/12/e031704.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850056848994992128
author Martin Veel Svendsen
Tonya Moen Hansen
Kirsten Brubakk
Dag Hofoss
paul Barach
Ole Tjomsland
author_facet Martin Veel Svendsen
Tonya Moen Hansen
Kirsten Brubakk
Dag Hofoss
paul Barach
Ole Tjomsland
author_sort Martin Veel Svendsen
collection DOAJ
description Objective This 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.Design A 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.Setting Fifty-six patient wards in 20 hospitals administered by the South-Eastern Norway Regional Health Authority.Participants In 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 measures The 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.Results The 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.Conclusion 7-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.
format Article
id doaj-art-9d41cc873f6c45899f8871e504665cd3
institution DOAJ
issn 2044-6055
language English
publishDate 2019-12-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-9d41cc873f6c45899f8871e504665cd32025-08-20T02:51:35ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-031704Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional surveyMartin Veel Svendsen0Tonya Moen Hansen1Kirsten Brubakk2Dag Hofoss3paul Barach4Ole Tjomsland52 Department of Occupational and Environmental Medicine, Sykehuset Telemark HF, Skien, Norway4 Department of Health Services Research, Folkehelseinstituttet, Oslo, Norway1 Department of Human Resources, Helse Sør-Øst RHF, Hamar, Norway3 Department of Postgraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway5 Pediatrics, Wayne State University, Detroit, Michigan, USA6 Director of Quality and Specialist Areas, South-Eastern Norway Regional Health Authority, Hamar, NorwayObjective This 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.Design A 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.Setting Fifty-six patient wards in 20 hospitals administered by the South-Eastern Norway Regional Health Authority.Participants In 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 measures The 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.Results The 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.Conclusion 7-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.https://bmjopen.bmj.com/content/9/12/e031704.full
spellingShingle Martin Veel Svendsen
Tonya Moen Hansen
Kirsten Brubakk
Dag Hofoss
paul Barach
Ole Tjomsland
Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey
BMJ Open
title Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey
title_full Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey
title_fullStr Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey
title_full_unstemmed Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey
title_short Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey
title_sort associations between work satisfaction engagement and 7 day patient mortality a cross sectional survey
url https://bmjopen.bmj.com/content/9/12/e031704.full
work_keys_str_mv AT martinveelsvendsen associationsbetweenworksatisfactionengagementand7daypatientmortalityacrosssectionalsurvey
AT tonyamoenhansen associationsbetweenworksatisfactionengagementand7daypatientmortalityacrosssectionalsurvey
AT kirstenbrubakk associationsbetweenworksatisfactionengagementand7daypatientmortalityacrosssectionalsurvey
AT daghofoss associationsbetweenworksatisfactionengagementand7daypatientmortalityacrosssectionalsurvey
AT paulbarach associationsbetweenworksatisfactionengagementand7daypatientmortalityacrosssectionalsurvey
AT oletjomsland associationsbetweenworksatisfactionengagementand7daypatientmortalityacrosssectionalsurvey