Safety-Specific Leadership, Goal Orientation, and Near-Miss Recognition: The Cross-Level Moderating Effects of Safety Climate

Rethinking frontline health workers' safety performance in times of pandemic: the role of spiritual leadership

This study examined the impact of spiritual leadership style on frontline health workers' safety performance through the mediating role of safety climate. Also, leader-member exchange (LMX) was examined as a moderator of the safety climate and safety performance relationship. Survey data from 582 frontline health workers in Ghana's Greater Accra and Ashanti regions were analyzed using AMOS version 23. Findings showed that spiritual leadership dimensions significantly influenced health workers' safety performance. Altruistic love and vision also significantly influenced safety climate. However, hope did not influenced safety climate. Moreover, safety climate had an impact onsafety performance dimensions. Furthermore, safety climate mediated the relationship between altruistic love, vision, and safety performance. However, safety climate did not mediate the relationship between hope and safety performance. Lastly, LMX moderated the positive effect of safety climate on safety compliance but not on safety participation. This study offers valuable insights for improving frontline health workers' safety performance during pandemics.

Association between abusive supervision and nurses' withholding voice about patient safety: the roles of impression management motivation and speak up-related climate

BACKGROUND

Abusive supervision by the nurse manager significantly influences nurses' withholding voice about patient safety. The role of impression management motivation and speak up-related climate is crucial in understanding their connection. This study aimed to explore the relationship between abusive supervision, impression management motivation, speak up-related climate, and withholding voice about patient safety.

METHODS

This cross-sectional study employed a convenience sampling method to recruit 419 clinical nurses from Taizhou Hospital, Zhejiang Province, China, between 1 November 2022 and 31 January 2023. The study adhered to the STROBE checklist. Abusive supervision and impression management motivation were assessed using the Chinese versions of the Abusive Supervision Scale and the Impression Management Motivation Scale, respectively. Withholding voice about patient safety and speak up-related climate were identified using the Chinese version of the Speaking Up about Patient Safety Questionnaire.

RESULTS

Nurse leaders' abusive supervision (β=0.40, p<0.01) and nurses' impression management motivation (β=0.10, p<0.01) significantly and positively influenced nurses' withholding voice about patient safety. We introduced impression management motivation as a mediating variable, and the effect of abusive supervision on nurses' withholding voice decreased (β from 0.40 to 0.38, p< 0.01). Nurses' speak up-related climate played a moderating role between abusive supervision and impression management motivation (β= 0.24, p<0.05).

CONCLUSIONS

Abusive supervision by nursing leaders can result in nurses withholding voice about patient safety out of self-protective impression management motives. This phenomenon inhibits nurses' subjective initiative and undermines their proactive involvement in improving patient safety, and hinders the cultivation of a culture encouraging full participation in patient safety, which should warrant significant attention.

Reconciling general transformational leadership and safety-specific transformational leadership: A paradox perspective

INTRODUCTION

Research exploring the relationship between transformational leadership and safety has used transformational leadership in context-free (e.g., "general transformational leadership," or GTL) and context-specific forms (e.g., "safety-specific transformational leadership," or SSTL), assuming these constructs are theoretically and empirically equivalent. In this paper, a paradox theory is drawn on (Schad, Lewis, Raisch, & Smith, 2016; Smith & Lewis, 2011) to reconcile the relationship between these two forms of transformational leadership and safety.

METHOD

This is done by: (a) investigating whether GTL and SSTL are empirically distinguishable; (b) testing the relative importance of GTL and SSTL in explaining variance in context-free work outcomes (i.e., in-role performance, organizational citizenship behaviors) and context-specific (i.e., safety compliance, safety participation); and (c) examining the extent to which perceived safety concern in the work environment renders GTL and SSTL distinguishable.

RESULTS

Two studies (one cross-sectional, one short-term longitudinal) show that GTL and SSTL are psychometrically distinct albeit highly correlated. Furthermore, SSTL explained statistically more variance than GTL in both safety participation and organizational citizenship behaviors, whereas GTL explained more variance in in-role performance than did SSTL. However, GTL and SSTL were only distinguishable in low-concern contexts but not high-concern contexts.

CONCLUSIONS AND PRACTICAL APPLICATIONS

These findings challenge the "either-or" (vs "both-and") approach to considering safety and performance, cautioning researchers to consider nuanced differences in context-free and context-specific forms of leadership and to avoid further proliferation of often redundant context-specific operationalizations of leadership.

Divergent effects of transformational leadership on safety compliance: A dual-path moderated mediation model

Research on the relationship between transformational leadership and safety compliance has yielded equivocal results. This study investigates how and when transformational leadership produces divergent effects on safety compliance. Using a time-lagged research design, we collect data from a sample of 309 employees in the Chinese construction industry to examine the hypothesized relationship. We find that transformational leadership positively affects safety compliance through employees’ felt obligation toward their leader. However, transformational leadership also negatively impacts safety compliance through safety risk tolerance. We further show that employees’ perception of the safety climate plays a contingent role in the above processes. Specifically, a high-level perceived safety climate strengthens the positive indirect effect of transformational leadership on safety compliance through felt obligation, while a low-level perceived safety climate strengthens the negative indirect effect of transformational leadership on safety compliance through safety risk tolerance. The theoretical and practical implications of the findings are also discussed.