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Leadership Styles and How Each They Can or Cannot Promote Patient Safety Essay Example

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Leadership Styles and How Each They Can or Cannot Promote Patient Safety


Patient safety can be defined as a discipline which stresses health care safety by means of reporting, reducing, preventing and analysing medical error that normally result in adverse effects. Leadership is the action of leading an organization or a group of people. Leadership is important for realising goals associated with patient safety and quality care. In the organisation, individuals are expected to show leadership qualities, from executives to the nurses working directly with the patients. Irrespective of where the care is delivered, long-term care facilities, inpatient units, and so forth, there must be leadership. Quality healthcare cannot be offered without patient safety. Transformational style of leadership is considered more suitable for creating conducive environments for patient safety. In the healthcare system, the safety of patients has always been a major concern and although many positive changes in regulations, health systems and practice have been made, the desired safety level is yet to be achieved. The health care leaders’ competency to manage constant change and create positive work environments is crucial to the success of the organizations and can promote patient safety. There is a significant relationship between insights of positive leadership practices in the culture of patient safety and the inclination to report an error, which is a symbol of safety culture. The objective of this piece is to describe transformational leadership, transactional Leadership, and Laissez-faire Leadership styles and critically analyse how these leadership styles may or may not promote patient safety.


In transactional leadership style, the leader ensures that the staffs adhere to the rules by introducing a system of punishments and rewards. In this leadership style, the followers are rewarded accordingly if they achieve the set targets and when they fail to reach and obey the goals, they are punished. This leadership style is focused firmly on the supervision of nurses, improving group performance, and making sure that the organisation runs smoothly. This style is effective in completing a project that is highly detailed and managing a crisis. As mentioned by Jennings, Disch and Senn, transactional leadership has a connection to alienative organizational commitment. The leadership involves elements of management by exception, contingent reward behaviour as well as action management through exclusion. Murphy (20) posits that management-by-exception is an attribute of transactional leadership, which includes an action initiation by the leader only after identifying an error or deviant act made by nurses with regard to performance. If a nurse is punished for an error, he/she could become demotivated; thus, affecting patient safety. Even though transactional leadership is somewhat valuable in a number of hospital settings, its efficacy depends on its inability to associate with or handle scores of intrinsic reasons why the majority of healthcare professionals are attracted to their work. Generally, transactional leadership does not recognize or embed this intrinsic commitment adequately. Still, transactional behaviours create a relationships basis between followers and leaders in the operating theatres and on the wards. Furthermore, there is some transactional behaviour which could be related theoretically to improved levels of patient safety. Transactional leaders who can monitor performance vigilantly can easily identify deviations and mistakes from good conditions and performance that could put the patients’ safety at risk. Ability to identify errors or deviations can help promote patient safety.

In transformational leadership, the followers normally pursue the behaviours exhibited by the leaders and are more motivated to change. Transformational leaders normally perform beyond all expectations and they always put their followers first. They offer a clear futuristic vision which inspires employees to work hard. In the health care environment, transformational leaders are inclined to reduce medication errors and the workers are likely to perform their tasks more carefully; thus, leading to improved patient safety. This style of leadership is associated with lower patient mortality and improved care and treatment. According to Ring and Fairchild (53), this style of leadership has a common effect on the satisfaction levels of the patients. Many patients are inclined to become happy with the service offered at the hospital. Transformational leaders reduce restraints since patients become more cooperative with the nurses. Besides the lower medication errors incidence, hospitals under this leadership style normally record fewer infections acquired in the hospital settings. The healthcare administrators that have espoused transformational behaviours are more inclined to promote patient safety since this leadership style involves shared decision making, collaboration, and transparency. Transformational leaders have high engagement level, which normally leads to increased motivation and enhanced patient outcomes. A transformational leader can change the existing behaviours, attitudes, as well as priorities with regard to how medical errors are identified and managed. When nursing leaders motivate their followers, medication errors will be reduced and patient satisfaction will be improved. As compared to other style of leadership, transformational leaders espouse a servitude mentality towards staff and patients with the aim of realising improved patient care. This normally result in reduced rates of medication errors as well as patient mortality.

In laissez-faire leadership style, leaders exercise little supervision and prefer taking their hands off the day-to-day operations. They prefer allowing other people to do what has to be done on their own since they believe that they will perform well without supervision. Even though this style of leadership promotes independent thinking, it can result in numerous negative consequences since crucial decisions are not made punctually. Furthermore, quality improvements can only take place when a situation arises. This leadership style cannot promote patient safety because the leaders are normally inexperienced and are still learning. As pointed out by Murphy (20), laissez-faire leaders often avoid making decisions; they ignore responsibilities; and have less authority. Essentially, the leader hardly makes any effort to assist the followers to meet their needs; thus, it is hard for the followers to grow. Given that there is a distinct gap in the leader-follower relationship and follower development, the employees are often dissatisfied due to lack of shared and clear direction from their leaders. According to Merrill (322), laissez-faire leadership leads to an environment where nurses work in a negative safety climate. This results in nursing insecurities since the nurses prefer being wrong instead of asking for help from their leaders. This style of leadership enables nurses to cut corners in order to make their leader see that they have spent their time well. Laissez-faire leaders are more inclined to find quick fixes, become hostile, and indecisive instead of investigating the root cause of a problem. This normally leads to demotivation amongst the employees and poor patient outcomes.

As pointed out by Murphy (41), transformational promotes patient safety, because the leader offers the followers the needed support; thus, leading to lower medication errors. A positive relationship between a leader and nurse can lead to a positive safety climate. When employees at the hospital environment are motivated, they are inclined to reduce medication errors and improve the patient outcomes. According to Merrill (15), nurses are likely to report better patient safety outcomes a leader play an important role in creating a positive environment for the workers and patients. There is a positive relationship between staff safety climate, nurses’ work environment, as well as nurse outcomes. Therefore, transformational leadership is inclined to promote safety climate and lead to improved nurses’ outcomes and patient safety. More importantly, nurses can use either transformational or transactional leadership behaviour to influence organisational outcomes in a positive way and have to appreciate the inter-relationship that exists between optimising patient outcomes, enhancing the quality of care and developing nursing practice. The hospitals need nurse leaders that can develop nursing care, monitor performance, and improve the work setting.


In conclusion, this piece has described transformational leadership, transactional Leadership, and Laissez-faire Leadership styles and has also critically analysed how these leadership styles may or may not promote patient safety. As mentioned in the paper, transformational leadership is the most suitable style that can promote patient safety. It contributes to safety climate, improves nurses’ outcomes and generates trust. On the other hand, laissez-faire leadership negatively affect the safety climate; therefore, does not promote patient safety. This paper has demonstrated why transformational leadership is important in improving the healthcare systems. Transactional leadership can also promote patient safety because the leader can easily identify deviations and mistakes from good conditions and performance that could put the patients’ safety at risk.

Work Cited

Jennings, Bonnie M., Joanne Disch and Laura Senn. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. April 2008. 30 July 2017. <https://www.ncbi.nlm.nih.gov/books/NBK2640/>.

Merrill, Katreena Collette. “Leadership Style and Patient Safety: Implications for Nurse Managers.” The Journal of Nursing Administration 45.6 (2015): 319-324.

—. The Relationship Among Nurse Manager Leadership Style, Span of Control, Staff Nurse Practice Environment, Safety Climate, and Nurse-Sensitive Patient Outcomes. Dissertation. The University of Utah. Salt Lake City, UT, 2011.

Murphy, Lara. Leadership, Nursing, and Patient Safety Within a Hospital-based Learning Organization. Thesis. The University of Western Ontario. London, ON, 2016.

Ring, Leeann and Roseanne Moody Fairchild. “Leadership and Patient Safety: A Review of the Literature.” Journal of Nursing Regulation 4.1 (2013): 52-56.