Staff retention and mortality
The importance of continuity of care Previous research suggests that survival of patients may be associated with hospital organisational culture.1 Organisational factors such as culture, staffing, and retention of staff are crucial to patient safety. In a linked study covering nine years of monthly data from all NHS acute trusts in England, Moscelli and colleagues showed that a high turnover of senior doctors (hospital consultants and specialty associated doctors) and nurses in hospitals is associated with increased mortality for patients admitted for emergencies.2 For the 30 day mortality risk, a 1 standard deviation increase in the monthly turnover rate of nurses was associated with a 0.052 (0.037 to 0.067) percentage point increase and of senior doctors was a 0.019 (0.006 to 0.033) percentage point increase. Extensive robustness checks give credibility to the findings , although such associations cannot be taken as proof of causality. Turnover rates among nurses showed a stronger as
