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Investigating the influence of selected leadership styles on patient safety and quality of care: a systematic review and meta-analysis
  1. Ankit Singh1,
  2. Rajiv Yeravdekar2,
  3. Sammita Jadhav1
  1. 1 Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, Maharashtra, India
  2. 2 Faculty of Medical and Health Sciences, Symbiosis International (Deemed University), Pune, Maharashtra, India
  1. Correspondence to Dr Ankit Singh; anktsngh15{at}gmail.com

Abstract

Background There is a popular belief that transformational leadership (TL) and servant leadership (SL) styles are influential in establishing a patient safety (PS) culture and improving the quality of care (QC). However, there are very few review articles investigating this phenomenon.

Purpose This study performs a systematic review and meta-analysis to ascertain the influences of TL and SL on PS and QC.

Methods Published research work indexed in the two popular databases, that is, Scopus and PubMed, was selected based on the inclusion criteria. The systematic review was performed as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data such as country of publication, year, data type, research design, target population, sample size and conclusion were selected from the studies.

Results There are pieces of evidence suggesting a medium to strong effect of TL on PS. At the same time, the effect of TL on QC is not direct but indirect and is mediated through variables such as fostering positive organisational culture and enhancing organisational outcomes such as job satisfaction, leader effectiveness and willingness of nurses to spend some extra effort. A total of 27 studies were selected for final evaluation and 11 reported a relationship between TL and PS. The ‘Fisher r-to-z transformed correlation coefficients’ ranged from 0.3769 to 0.8673. Similarly, a total of four studies reported the relationship between TL and QC, ‘Fisher r-to-z transformed correlation coefficients’ ranged from 0.0802 to 0.5101, with most estimates being positive (80%).

Conclusion TL has a strong and positive effect on PS but a positive and weak effect on the QC. There is not much evidence to establish SL’s influence on PS and QC.

  • patient safety
  • behaviour
  • leadership assessment
  • patient-centred care

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • X @anktsngh15

  • Contributors AS conceived and designed the overall structure and scope of the review article. AS also conducted extensive literature research and analysis to gather relevant information. RY contributed significantly to writing sections and assisted in developing the conceptual framework and organising the content. SJ conducted critical analyses of the data and synthesised key findings. AS is the guarantor for this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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