Leadership Behavior Associations with Domains of Safety Culture, Engagement, and Health Care Worker Well-Being

被引：16

作者：

Tawfik, Daniel S. ^{[1
]}

Adair, Kathryn C. ^{[2
]}

Palassof, Sofia ^{[3
]}

Sexton, Bryan J. ^{[4
,5
]}

Levoy, Emily ^{[6
]}

Frankel, Allan ^{[7
]}

Leonard, Michael ^{[7
]}

Proulx, Joshua ^{[7
]}

Profit, Jochen ^{[8
,9
]}

机构：

[1] Stanford Univ, Sch Med, Dept Pediat, Div Pediat Crit Care Med, Stanford, CA 94305 USA

[2] Duke Univ Hlth Syst, Duke Ctr Healthcare Safety & Qual, Wellbeing & Res, Durham, NC USA

[3] Univ Freiburg, Dept Med Psychol & Med Sociol, Freiburg, Germany

[4] Duke Univ, Sch Med, Dept Psychiat, Durham, NC 27706 USA

[5] Duke Univ Hlth Syst, Duke Ctr Healthcare Safety & Qual, Durham, NC USA

[6] Stanford Univ, Sch Med, Dept Pediat, Stanford, CA 94305 USA

[7] Safe & Reliable Healthcare, Evergreen, CO USA

[8] Stanford Univ, Sch Med, Dept Pediat, Perinatal Epidemiol & Hlth Outcomes Res Unit,Div, Stanford, CA 94305 USA

[9] Calif Perinatal Qual Care Collaborat, Palo Alto, CA USA

来源：

JOINT COMMISSION JOURNAL ON QUALITY AND PATIENT SAFETY | 2023年 / 49卷 / 03期

基金：

美国医疗保健研究与质量局;

关键词：

EFFORT-REWARD IMBALANCE; PSYCHOLOGICAL SAFETY; TRANSFORMATIONAL LEADERSHIP; AUTHENTIC LEADERSHIP; BURNOUT; CLIMATE; ANTECEDENTS;

D O I：

10.1016/j.jcjq.2022.12.006

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Leadership 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.Methods: The SCORE survey was administered to 31 Midwestern hospitals as part of a broad effort to measure care con-text, 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 do-mains, adjusted for role and work-setting characteristics.Results: Of 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.Conclusion: Local 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.

引用

页码：156 / 165

页数：10

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