The role of leadership in learning culture and patient safety

Abstract

Patient safety improvement through management has been a prime issue since 2000, when the Institute of Medicine reported that preventable mismanagement was responsible for the majority of medical errors. Learning culture, interdisciplinary action teams, and punitive culture have been discussed as viable ways to address these errors. While these individual factors have been found to be significant, we have yet to understand the interactions of these elements. The role of leadership, which has been overlooked, is critical to facilitate or constrain these elements. The interactions of these three elements and the role of leadership were analyzed using structural equation modeling. Our finding revealed the three elements were closely knitted, and leadership roles had considerable impact in nurturing learning culture and constraining punitive culture, which in turn enhanced patient safety.

Developing a Workplace-Based Learning Culture in the NHS: Aspirations and Challenges

“…Good leadership encourages employees to collaborate with other team members, and enables employees to provide the best care for patients while learning from errors. 16,22,23 Therefore, it is clear that supportive, collaborative leadership is likely to enhance learning culture while dissuading punitive culture.…”

Safety Culture at Primary Healthcare Level: A Cross-Sectional Study among Employees with a Leadership Role

“…Namely, the role of leadership is critical to facilitate or constrain a positive safety culture. They can crucially affect a positive interdisciplinary action team, and a positive learning culture but, on the other hand, diminish a punitive culture (27). Leaders are in a position to enable a culture of safety (28,29).…”

From transactional to transformational

“…Research suggests that leaders who view themselves as transformational hold a higher learning orientation, and foster this learning stance among their followers, whereas transactional leaders emphasise performance over learning (Pastor and Mayo, 2008). In practice, transformational leaders encourage employees to take intelligent risks, challenge assumptions, bring forth innovative ideas, support changes to the organisation's culture, experiment with new ways of working and seek learning opportunities (Gong et al, 2009;Kim and Newby-Bennett, 2012;Sattayaraksa and Boon-itt, 2016;Shao et al, 2017). In contrast, transactional leaders tend to emphasise institutionalised learning through control, standardisation and formalisation (Vera and Crossan, 2004), and to encourage employees to operate within the confines of the current organisational culture and systems (Shao et al, 2017).…”