A relational leadership perspective on unit-level safety climate.
OBJECTIVE
This study compared nursing staff perceptions of safety climate in clinical units characterized by high and low ratings of leader-member exchange (LMX) and explored characteristics that might account for differences.


BACKGROUND
Frontline nursing leaders' actions are critical to ensure patient safety. Specific leadership behaviors to achieve this goal are underexamined. The LMX perspective has shown promise in nonhealthcare settings as a means to explain safety climate perceptions.


METHODS
Cross-sectional survey of staff (n = 711) and unit directors from 34 inpatient units in an academic medical center was conducted.


RESULTS
Significant differences were found between high and low LMX scoring units on supervisor safety expectations, organizational learning-continuous improvement, total communication, feedback and communication about errors, and nonpunitive response to errors.


CONCLUSIONS
The LMX perspective can be used to identify differences in perceptions of safety climate among nursing staff. Future studies are needed to identify strategies to improve staff safety attitudes and behaviors.
School of Nursing, University of Pittsburgh, Room 450, Victoria Bldg, Pittsburgh, PA 15261, USA. djt17@pitt.edu
Debra N
DN
Thompson
Leslie A
LA
Hoffman
Susan M
SM
Sereika
Holly L
HL
Lorenz
Gail A
GA
Wolf
Helen K
HK
Burns
Tamra E
TE
Minnier
Rangaraj
R
Ramanujam
D000046:Academic Medical Centers; D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D006757:Hospital Units; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D008875:Middle Aged; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000523:psychology*; D015279:Organizational Culture; D017751:Safety Management / Q000458:organization & administration*