The association between transformational leadership in German hospitals and the frequency of events reported as perceived by medical directors

This paper aimed to evaluate how transformational leadership behaviour is associated with patient safety culture in a hospital context. In line with findings from other high-hazard industries, we predicted that in hospitals, executives' perceived emphasis on transformational behaviour would positively influence the frequency of events reported by staff on the front line of service provision. Our hypothesis was confirmed by fitting a multivariable regression model to a sample of 507 medical directors of German acute-care hospitals. Results revealed transformational leadership in hospitals was a significant predictor of the reporting frequency of safety events, as perceived by medical directors. Our findings highlighted the critical role that executive behaviour plays in staff participation in patient safety initiatives. Preventing patients from unintended harm can then be traced back to the organisational level that is the farthest away from direct patient interaction. Consequently, these findings may provide guidance for hospitals aiming to raise employees' awareness of patient safety and prevent unintended patient harm prospectively.