Leadership Styles and Safety Performance among Employees in Healthcare Facilities: A Systematic Review

Mahdi Jafari  Nodoushan; Amir Houshang  Mehrparvar; Mohammad Ali Ghoveh  Nodoushan; Reza Jafari  Nodoushan; Ali  Karimi

doi:10.18502/jhsw.v15i2.21407

Mahdi Jafari Nodoushan Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Amir Houshang Mehrparvar Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Mohammad Ali Ghoveh Nodoushan Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Reza Jafari Nodoushan Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Ali Karimi Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jhsw.v15i2.21407

Keywords: Leadership style, Transformational leadership, Safety performance, Healthcare settings

Abstract

Introduction: Safety in healthcare facilities is critically important for the health and well-being ofemployees, patients, and organizational effectiveness. In recent years, various studies have examined therelationship between leadership styles or approaches and safety performance as one of the indicators ofsafety promotion. The present systematic review examines the relationship between different leadershipstyles and the safety performance of employees in healthcare facilities to provide a better understandingof the positive or negative effects of leadership on safety and to suggest strategies for improving safetyperformance in healthcare facilities.

Material and Methods: A search was conducted in Scopus, PubMed, and Web of Science (ISI) databases.Keywords related to leadership, safety performance, and healthcare employees were used. Studiespublished up to the end of 2024 were identified and reviewed in accordance with PRISMA guidelines.

Results: Nineteen relevant papers were selected and included in the study. During the review of studies,eleven leadership styles or approaches were identified in relation to safety performance in varioushealthcare facilities. These included transformational leadership, leader-member exchange leadership,leader safety priority communication and feedback, ethical leadership, empowering leadership,inconsistent and destructive leadership, transactional leadership, task-oriented leadership, authenticleadership, safety leadership, and servant leadership. All leadership styles except for inconsistent anddestructive leadership had a direct or indirect positive effect on safety performance. Also, the largestnumber of studies (n=4) focused on transformational leadership style and leader-member exchangeleadership.

Conclusion: The selection of appropriate leadership styles can contribute to enhanced safety, a reductionin occupational incidents, and improving service quality in healthcare settings. The findings of thisstudy highlight the importance of developing effective leadership styles and strengthening appropriatemanagerial approaches to improve safety in healthcare facilities