Patient safety and leadership style in the government general hospitals in Kuwait: a multi-method study

Nursing leadership style and error management culture: a scoping review

PURPOSE

This paper aims to assess the influence of nursing leadership style on error management culture (EMC).

DESIGN/METHODOLOGY/APPROACH

This scoping review was conducted following the integrative review methodology of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, CINAHL, Scopus, Web of Science, Embase and EBSCO databases were systematically searched to identify studies on nursing leadership, error management and measurement, and error management culture. The studies' methodological quality was then assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies.

FINDINGS

Thirteen manuscripts were included for review. The analysis confirmed that nursing leadership plays an important role in EMC and nurses' intention to report errors. Three emerging themes were identified: 1) leadership and EMC; 2) leadership and the intention to report errors; and 3) leadership and error rate.

RESEARCH LIMITATIONS/IMPLICATIONS

A major limitation of the studies is that errors are often analyzed in a transversal way and associated with patient safety, and not as a single concept.

PRACTICAL IMPLICATIONS

Healthcare managers should promote training dedicated to head nurses and their leadership style, for creating a good work environment in which nurses feel free and empowered to report errors, learn from them and prevent their reoccurrence in the future.

ORIGINALITY/VALUE

There is a positive relationship between nursing leadership and error management in terms of reduced errors and increased benefits. Positive nursing leadership leads to improvements in the caring quality.

Investigating the influence of selected leadership styles on patient safety and quality of care: a systematic review and meta-analysis

BACKGROUND

There is a popular belief that transformational leadership (TL) and servant leadership (SL) styles are influential in establishing a patient safety (PS) culture and improving the quality of care (QC). However, there are very few review articles investigating this phenomenon.

PURPOSE

This study performs a systematic review and meta-analysis to ascertain the influences of TL and SL on PS and QC.

METHODS

Published research work indexed in the two popular databases, that is, Scopus and PubMed, was selected based on the inclusion criteria. The systematic review was performed as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data such as country of publication, year, data type, research design, target population, sample size and conclusion were selected from the studies.

RESULTS

There are pieces of evidence suggesting a medium to strong effect of TL on PS. At the same time, the effect of TL on QC is not direct but indirect and is mediated through variables such as fostering positive organisational culture and enhancing organisational outcomes such as job satisfaction, leader effectiveness and willingness of nurses to spend some extra effort. A total of 27 studies were selected for final evaluation and 11 reported a relationship between TL and PS. The 'Fisher r-to-z transformed correlation coefficients' ranged from 0.3769 to 0.8673. Similarly, a total of four studies reported the relationship between TL and QC, 'Fisher r-to-z transformed correlation coefficients' ranged from 0.0802 to 0.5101, with most estimates being positive (80%).

CONCLUSION

TL has a strong and positive effect on PS but a positive and weak effect on the QC. There is not much evidence to establish SL's influence on PS and QC.

Leadership to promote patient safety culture in public hospitals managed by social health organizations

PURPOSE

This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.

DESIGN/METHODOLOGY/APPROACH

Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.

FINDINGS

Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.

RESEARCH LIMITATIONS/IMPLICATIONS

All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents' profiles, demographic variables were not analyzed.

PRACTICAL IMPLICATIONS

This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.

ORIGINALITY/VALUE

This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

The Impact of Transformational Leadership in the Nursing Work Environment and Patients' Outcomes: A Systematic Review

BACKGROUND

With the increasingly demanding healthcare environment, patient safety issues are only becoming more complex. This urges nursing leaders to adapt and master effective leadership; particularly, transformational leadership (TFL) is shown to scientifically be the most successfully recognized leadership style in healthcare, focusing on relationship building while putting followers in power and emphasizing values and vision.

AIM

To examine how transformational leadership affects nurses' job environment and nursing care provided to the patients and patients' outcomes.

DESIGN

A systematic literature review was conducted. From 71 reviewed, 23 studies were included (studies included questionnaire surveys and one interview, extracting barriers and facilitators, and analyzing using qualitative synthesis).

RESULT

TFL indirectly and directly positively affects nurses' work environment through mediators, including structural empowerment, organizational commitment, and job satisfaction. Nurses perceived that managers' TFL behavior did not attain excellence in any of the included organizations, highlighting the necessity for additional leadership training to enhance the patient safety culture related to the non-reporting of errors and to mitigate the blame culture within the nursing environment.

CONCLUSION

Bringing more focus to leadership education in nursing can make future nursing leaders more effective, which will cultivate efficient teamwork, a quality nursing work environment, and, ultimately, safe and efficient patient outcomes. This study was not registered.

Transformational health-care leaders in collaborative entrepreneurial model to achieve UNSDG: a qualitative study

PURPOSE

The agglomeration of specialist health-care facilities has often been restricted to metropolitan areas. This study aims to understand how health-care professionals with transformational leadership behaviors and entrepreneurial aims with a similar vision and expertise play pertinent roles in providing essential specialized health care in rural and semi-urban areas and achieving the United Nations Sustainable Development Goals (UNSDGs).

DESIGN/METHODOLOGY/APPROACH

Qualitative synthesis using focused-group discussions and interviews was conducted in a phased manner. For this, this study has used stakeholder-theory, and dynamic-capabilities approaches.

FINDINGS

This study explores the intricacies of collaborative entrepreneurship (CE)-based health-care ventures in developing regions and reveals five pertinent attributes: strategic control, synergy, commitment, empathy and satisfaction. This study recommends that entrepreneurial collaboration, especially by transformational health-care leaders, can significantly contribute to creating an endogenous health-care ecosystem with advanced facilities and technology-enabled modern infrastructure and augmenting regional development.

RESEARCH LIMITATIONS/IMPLICATIONS

This study was conducted in semi-urban settings in India. Future research should include other sectors and regions to generalize the findings.

PRACTICAL IMPLICATIONS

This study benefits health-care professionals having an analogous vision, skills and entrepreneurial aims.

SOCIAL IMPLICATIONS

Collaboration of health-care professionals and using transformational leadership behaviors can considerably contribute to providing specialist health care in developing areas and enhance patient satisfaction.

ORIGINALITY/VALUE

To the best of the authors' knowledge, this is the first study to discuss the importance of CE in health care in developing areas. In addition, it discusses the benefits of the CE model in achieving the UNSDGs and offers valuable suggestions for health-care professionals and administrators.