Leadership, safety climate, and continuous quality improvement: Impact on process quality and patient safety

There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals.

This research models shows how transformational leadership, safety climate and continuous quality improvement initiatives are related to objective quality and patient safety outcome measures.

The results provide empirical evidence that a safety climate connected to the CEO's transformational leadership style is related to CQI initiatives that are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes.

The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.