Published: 07/03/2002, Volume II2, No. 5795 Page 7

Good human resources practice in hospitals appears to improve patient mortality rates, a study has shown.

Research at Aston Business School has shown 'a strong relationship' between good HR practices - such as appraisals, teamworking and training - and mortality rates in acute hospitals, director of research Professor Michael West told delegates at the NHS Service Delivery Organisation research and development conference in London last week.

The research carried out at 61 acute hospitals examined HR practices across all occupational groups as well as deaths following emergency surgery, deaths following hip fracture and overall mortality rates. The study was controlled for factors such as the number of doctors per bed, local health needs and hospital size.

Professor West said: 'We could explain 33 per cent of the variation between hospitals on the basis of a knowledge of HR management practices. There is a pretty strong relation, such that better peoplemanagement practices is associated with lower mortality.'

Appraisals had the strongest association with lower mortality rates, he said, with an improvement of one standard deviation in the extensiveness or sophistication of appraisals linked with a 12.3 per cent reduction in deaths following hip fracture. He added: 'If the HR director in the trust is a voting member of the board, these relations are even stronger.'

In unpublished further research, Professor West has used mortality data compiled by Imperial College of Science, Technology and Medicine emeritus professor Brian Jarman to carry out a longitudinal study which shows that HR practices in hospitals predict subsequent patient mortality.

Professor West said the data indicated that 'the relationship is from HR [practices] to patient mortality, and not the reverse'.

The new data showed that 'HR practices are the only significant predictors of subsequent patient mortality when we take account of the prior mortality levels prevailing in the hospitals we studied', he added 'What it indicates is that peoplemanagement practices in the health service, just as in the private [industry] sector, is a very powerful contributor to the performance of the organisation. In a sense, There is no more powerful indicator about the performance of an acute hospital than patient deaths.'