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The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care.

We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit.

We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level.

This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

The effect of hotel employee safety behavior has not as yet been investigated. The purpose of this research is to determine the impact of hotel employee ternary safety behavior on negative safety outcomes, as well as the moderation effects of job vigor and emotional exhaustion.

A questionnaire survey of 16 medium- and high-star-rated hotels in southeast China was conducted and 571 responses were received for model estimation. The statistical analysis techniques adopted were confirmatory factor analysis, correlation analysis, hierarchical regression, and structural equation modeling.

The results showed that: (1) safety compliance and participation positively predicted safety adaptation; (2) the three dimensions of safety behavior contributed to reducing negative safety outcomes, and there was a multiple mediation process in their relationship; and (3) job vigor positively moderated the influence of safety compliance and adaption on negative safety outcomes, and emotional exhaustion negatively moderated the influence of safety participation on negative safety outcomes.

This research provides greater insights into the relationship between safety behavior and outcome performance within the hotel industry, and yields theoretical and practical implications for improving employee safety behavior and hotel safety performance.

Incentives are effective at enhancing productivity, but research also suggests that performance incentives can have “unintended negative consequences” including increases in hazard/injuries, increases in errors, and reduction in cooperation, prosocial behaviors, and creativity. Relatively overlooked is whether, when, and how incentives can be designed to prevent such negative consequences. The authors review literature in several disciplines (construction, healthcare delivery, economics, psychology, and [some] management) on this issue. This chapter, in toto, sheds a generally positive light and suggests that, beyond productivity, incentives can be used to improve other outcomes such as safety, quality, prosocial behaviors, and creativity, particularly when the incentives are thoughtfully designed. The review concludes with several potential fruitful areas for future research such as investigations of incentive-effect duration.

This study aims to examine the relationship between concrescent conversation environment (CCE), psychological safety and team effectiveness. Although CCE has been known to influence team outcomes, little is known about how it influences them. Integrating the social constructionist and social psychology perspectives, this study argues that CCE ignites a climate of psychological safety resulting in “joint-action” necessary for positive team outcomes.

Survey data were collected from 301 team members from US firms operating in different industries. Data were analyzed using SmartPLS.

The study establishes CCE as an antecedent to psychological safety and demonstrates that psychological safety mediates the relationship between CCE and team effectiveness.

This is one of the initial studies to show how verbal behaviors socially construct team dynamics in the shape of psychological safety to influence team outcomes. In doing so, the authors advance the theory pertaining to the role of social exchanges in team processes and outcomes.

The results provide insights on how managers can improve team outcomes by influencing the conversational environment of the team to elicit feelings of psychological safety. The results also suggest that managers must focus on relational outcomes as well, along with performance outcomes.

From a social constructionist perspective, team development is built upon the verbal behaviors of the members as they pursue tasks. However, the extant group dynamics literature undervalues conversations’ role in team processes and outcomes. This is the first study that examines the link between a team's conversational environment, psychological safety and team outcomes.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

The modern workplace contains many physical and interpersonal hazards to employee physical and psychological health/well-being. This chapter integrates the literatures on occupational safety (i.e., accidents and injuries) and mistreatment (physical violence and psychological abuse). A model is provided linking environmental (climate and leadership), individual differences (demographics and personality), motivation, behavior, and outcomes. It notes that some of the same variables have been linked to both safety and mistreatment, such as safety climate, mistreatment climate, conscientiousness, and emotional stability.

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established through modification in employee safety perspective and work behavior, human resource (HR) professionals need to contribute to this developing organizational domain. The IOM indicates individual employee behaviors cumulatively provide the primary antecedent for organizational safety and quality outcomes. Yet, many safety culture scholars indicate the concept is neither theoretically defined nor consistently applied and researched as the terms safety culture, safety climate, and safety attitude are interchangeably used to represent the same concept. As such, this paper examines the intersection of organizational culture and healthcare safety by analyzing the theoretical underpinnings of safety culture, exploring the constructs for measurement, and assessing the current state of safety culture research. Safety culture draws from the theoretical perspectives of sociology (represented by normal accident theory), organizational psychology (represented by high reliability theory), and human factors (represented by the aviation framework). By understanding not only the origins but also the empirical safety culture research and the associated intervention initiatives, healthcare professionals can design appropriate HR strategies to address the system characteristics that adversely affect patient outcomes. Increased emphasis on human resource management research is particularly important to the development of safety cultures. This paper contributes to the existing healthcare literature by providing the first comprehensive critical analysis of the theory, research, and practice that comprise contemporary safety culture science.

Hospitals within the United States consistently have injury rates that are over twice the national employee injury rate. Hospital safety studies typically investigate care providers rather than support service employees. Compounding the lack of evidence for this understudied population is the scant evidence that is available to examine the relationship of support service employees’ perceptions of safety and work-related injuries. To examine this phenomenon, the purpose of this study was to investigate support service employees’ perceptions of safety leadership and social support as well as the relationship of safety perception to levels of reported injuries.

A nonexperimental survey was conducted with the data collected from hospital support service employees (n=1,272) and examined: (1) relationships between safety leadership (supervisor and organization) and individual and unit safety perceptions; (2) the moderating effect of social support (supervisor and coworker) on individual and unit safety perceptions; and (3) the relationship of safety perception to reported injury rates. The survey items in this study were based on the items from the AHRQ Patient Safety Culture Survey and the U.S. National Health Care Surveys.

Safety leadership (supervisor and organization) was found to be positively related to individual safety perceptions and unit safety grade as was supervisor and coworker support. Coworker support was found to positively moderate the following relationships: supervisor safety leadership and safety perceptions, supervisor safety leadership and unit safety grade, and senior management safety leadership and safety perceptions. Positive employee safety perceptions were found to have a significant relationship with lower reported injury rates.

These findings suggest that safety leadership from supervisors and senior management as well as coworker support has positive implications for support service employees’ perceptions of safety, which, in turn, are negatively related to lower odds of reporting injuries.

The purpose of this paper is to investigate the relationship between organizational safety climate and organizational health performance outcomes (i.e. absenteeism, presenteeism, health care utilization) mediated by individual worker health. The authors used three pathways to examine this relationship: a physical pathway starting with physical safety climate and mediated by musculoskeletal disorders (MSDs), a psychosocial pathway starting with psychosocial safety climate and mediated by emotional exhaustion, and a combined pathway starting with psychosocial safety climate and mediated by both MSDs and emotional exhaustion.

Three mediational multilevel analyses were conducted using a sample of 8,761 employees working in 177 health care organizations.

Although the findings did not support the hypothesized physical pathway, they showed that the psychosocial pathway worked satisfactorily for two of the three health performance outcomes (absenteeism and presenteeism). The combined physical and psychosocial pathway explained differences in the third outcome: health care utilization.

This is one of the few studies to include both physical and psychosocial pathways that lead to employee health and organizational performance. The results underscore the importance of paying attention to psychological health and safety in the health care workplace. Not only for the psychological health of employees, but also to improve their physical health and subsequent organizational health performance.

The purpose of this paper is to develop and present a safety-oriented job demands-resources (JD-R) model that supports the notion that excessive job demands in the fire service, when not controlled or countered, may increase firefighter burnout and diminish firefighter safety.

The approach for the present project includes a review of the JD-R literature and the presentation of a conceptual model specific to fire service organizations.

A conceptual model, relevant to fire service organizations was derived. The model argues that excessive job demands associated with workload, physical demands, emotional demands, and complexity can result in burnout if not controlled or countered. Safety-specific resources, including recovery, support, safety-specific transformational leadership and safety climate are theorized to buffer these effects and are suggested to enhance firefighter engagement. These effects are argued then to improve firefighter safety. Ultimately, the findings will help guide future research, intervention projects and workplace safety and health management programs and initiatives.

This paper and conceptual model extends the application of the JD-R model to fire service organizations. Further, the conceptual model supports the application of safety-specific job resources vs more traditional job resources as a means to enhance firefighter safety.