ArticleJoint Commission journal on quality and patient safety2023
Leadership Behavior Associations with Domains of Safety Culture, Engagement, and Health Care Worker Well-Being.
Article in Joint Commission journal on quality and patient safety, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Supporting Cultural and Learning Enablers for a Learning Health System (SCALE): A Program Theory Approach.Learning health systems · 2026Article
- The Role of Surveillance in the Association Between the Nurse Work Environment and Patient Safety Culture.Research in nursing & health · 2026Article
- A Self-Determination Perspective in Healthcare: Leader-Member Exchange and Job Satisfaction in an Italian Sample.Healthcare (Basel, Switzerland) · 2026Article
- Short-Form Measures of Well-Being Centered Leadership for Matrixed Healthcare Systems.Journal of healthcare leadership · 2026Article
- The Influence of Organizational and Social Work Environmental Factors on Patient Safety Climate.Journal of nursing management · 2026Article
- Patient safety management activities partially mediate nursing competences and patient safety culture in Vietnam.PloS one · 2026Observational
- 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
- Safety culture in paediatric emergency departments: a cross-sectional study among healthcare professionals.BMJ open · 2025Article
- Association of well-being-centered leadership with burnout and professional fulfillment among physicians: mediating effects of autonomy support and self-valuation.Leadership in health services (Bradford, England) · 2025Article
- Job stress and patient safety culture: a qualitative study among hospital nurses in Palestine.BMC nursing · 2025Article
- The impact of leadership style in team-based primary care - staff satisfaction and motivation.BJGP open · 2024Article
- Psychological safety is associated with better work environment and lower levels of clinician burnout.Health affairs scholar · 2024Article
- An Organizational Leadership Development Approach to Support Health Worker Mental Health.American journal of public health · 2024Article
- Work Climate, Improved Communication, and Cohesive Work Linked with Patient Safety Culture: Findings from a Sports Medicine Hospital.Healthcare (Basel, Switzerland) · 2023Article
- Restoring Well-Being for Physicians Through Lifestyle Medicine.American journal of lifestyle medicineArticle
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Authors and funding
9 authors.
Funding
Abstract
backgroundLeadership is a key driver of health care worker well-being and engagement, and feedback is an essential leadership behavior. Methods for evaluating interaction norms of local leaders are not well developed. Moreover, associations between local leadership and related domains are poorly understood. This study sought to evaluate health care worker leadership behaviors in relation to burnout, safety culture, and engagement using the Local Leadership scale of the Safety, Communication, Operational Reliability, and Engagement (SCORE) survey.
methodsThe SCORE survey was administered to 31 Midwestern hospitals as part of a broad effort to measure care context, with domains including Local Leadership, Emotional Exhaustion/Burnout, Safety Climate, and Engagement. Mixed-effects hierarchical logistic regression was used to evaluate the relationships between local leadership scores and related domains, adjusted for role and work-setting characteristics.
resultsOf the 23,853 distributed surveys, 16,797 (70.4%) were returned. Local leadership scores averaged 68.8 ± 29.1, with 7,338 (44.2%) reporting emotional exhaustion, 9,147 (55.9%) reporting concerning safety climate, 10,974 (68.4%) reporting concerning teamwork climate, 7,857 (47.5%) reporting high workload, and 3,436 (20.7%) reporting intentions to leave. Each 10-point increase in local leadership score was associated with odds ratios of 0.72 (95% confidence interval [CI] 0.71-0.73) for burnout, 0.48 (95% CI 0.47-0.49) for concerning safety climate, 0.64 (95% CI 0.63-0.66) for concerning teamwork climate, 0.90 (95% CI 0.89-0.92) for high workload, and 0.80 (95% CI 0.78-0.81) for intentions to leave, after adjustment for unit and provider characteristics.
conclusionLocal leadership behaviors are readily measurable using a five-item scale and strongly associate with established domains of health care worker well-being, safety culture, and engagement.
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