Observational studyBMC health services research2019
The role of psychological safety and learning behavior in the development of effective quality improvement teams in Ghana: an observational study.
Observational study in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 46 citations in OpenAlex.
- The impact of team psychological safety, occupational coping efficacy, and job satisfaction on the job performance of operating room nurses: an empirical study based on structural equation modeling.Frontiers in public health · 2026Article
- Occupational exposure risk perception and its multilevel influencing factors among nurses in central sterile supply departments: a cross-sectional study based on the social ecological model.Frontiers in public health · 2026Article
- Champions as catalysts for change: a realist evaluation of their impact in primary care.BMC health services research · 2025Article
- Structural modelling of student volleyball athletes' intimacy, social adjustment, perceived stress, and learning-related anxiety: mediating role of psychological safety.BMC psychology · 2025Article
- The Role of Servant Leadership in Fostering Psychological Safety Among Nurses in Jordanian Hospitals.Journal of nursing management · 2025Article
- Trust-building in temporary public health partnerships: a qualitative study of the partnership formation process of a Covid-19 test, trace and protect service.BMC health services research · 2024Article
- Perceived Academic Team Leaders' Authentic Leadership and Team Members' Psychological Safety: A Cross-Sectional Online Survey.Journal of nursing management · 2024Article
- Article
- "If you work alone on this project, you can't reach your target": unpacking the leader's role in well-performing teams in a maternal and neonatal quality improvement programme in South Africa, before and during COVID-19.BMC health services research · 2023Article
- From purists to pragmatists: a qualitative evaluation of how implementation processes and contexts shaped the uptake and methodological adaptations of a maternal and neonatal quality improvement programme in South Africa prior to, and during COVID-19.BMC health services research · 2023Article
- An Evidence-Informed Framework to Promote Mental Wellbeing in Elite Sport.Frontiers in psychology · 2022Review
- A concept analysis of psychological safety: Further understanding for application to health care.Nursing open · 2022Article
- Aiming for quality: a global compass for national learning systems.Health research policy and systems · 2021Review
- Enhancing psychological safety in mental health services.International journal of mental health systems · 2021Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAs lower-income countries look to develop a mature healthcare workforce and to improve quality and reduce costs, they are increasingly turning to quality improvement (QI), a widely-used strategy in higher-income countries. Although QI is an effective strategy for promoting evidence-based practices, QI interventions often fail to deliver desired results. This failure may reflect a problem with implementation. As the key implementing unit of QI, teams are critical for the success or failure of QI efforts. Thus, we used the model of work-team learning to identify factors related to the effectiveness of newly-formed hospital-based QI teams in Ghana.
methodsThis was a cross-sectional, observational study. We used structural equation modeling to estimate relationships between coaching-oriented team leadership, perceived support for teamwork, team psychological safety, team learning behavior, and QI implementation. We used an observer-rated measure of QI implementation, our outcome of interest. Team-level factors were measured using aggregated survey data from 490 QI team members, resulting in a sample size of 122 teams. We assessed model fit and tested significance of standardized parameters, including direct and indirect effects.
resultsLearning behavior mediated a positive relationship between psychological safety and QI implementation (β = 0.171, p = 0.001). Psychological safety mediated a positive relationship between team leadership and learning behavior (β = 0.384, p = 0.068). Perceived support for teamwork did not have a significant effect on psychological safety or learning behavior.
conclusionsPsychological safety and learning behavior are key for the success of newly formed QI teams working in lower-income countries. Organizational leaders and implementation facilitators should consider these leverage points as they work to establish an environment where QI and other team-based activities are supported and encouraged.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.