Healthcare CEOs' Leadership Style and Patient Safety

Abstract

Concern about patient safety in healthcare has generally concentrated on the clinical actions and behaviors of the front line staff, those at the so-called ‘sharp end’ or operational level of the institution who provide direct patient care. Workers and their supervisors receive the most scrutiny due to their proximity to adverse events and many interventions, for example training and error/incident reporting systems are targeted at this level of staff. Cultural assessment tools also often focus exclusively on direct care providers. What is frequently overlooked is the role of senior leaders (e.g. Chief Executive Officer (CEO)) and the influence their style and priorities can have on patient safety. This study presents some of the first data on healthcare CEOs' leadership style with respect to patient safety in the United Kingdom (UK) and Canada. We found that transformational leadership and contingent reward were significantly correlated with perceptions of safety climate at executive director level. Furthermore, healthcare CEOs who routinely prioritized patient safety were rated significantly higher on safety climate by the executive directors who report to them.