title: Behavioral integrity for safety, priority of safety, psychological safety, and patient safety: a team-level study.
abstract: This article clarifies how leader behavioral integrity for safety helps solve follower's double bind between adhering to safety protocols and speaking up about mistakes against protocols. Path modeling of survey data in 54 nursing teams showed that head nurse behavioral integrity for safety positively relates to both team priority of safety and psychological safety. In turn, team priority of safety and team psychological safety were, respectively, negatively and positively related with the number of treatment errors that were reported to head nurses. We further demonstrated an interaction effect between team priority of safety and psychological safety on reported errors such that the relationship between team priority of safety and the number of errors was stronger for higher levels of team psychological safety. Finally, we showed that both team priority of safety and team psychological safety mediated the relationship between leader behavioral integrity for safety and reported treatment errors. These results suggest that although adhering to safety protocols and admitting mistakes against those protocols show opposite relations to reported treatment errors, both are important to improving patient safety and both are fostered by leaders who walk their safety talk.
authors.affiliation: Faculty of Business and Economics, KU Leuven, Naamsestraat 69–Post Box 3545, 3000 Leuven, Belgium. hannes.leroy@econ.kuleuven.be
authors.forename: Hannes
authors.initials: H
authors.lastname: Leroy
authors.forename: Bart
authors.initials: B
authors.lastname: Dierynck
authors.forename: Frederik
authors.initials: F
authors.lastname: Anseel
authors.forename: Tony
authors.initials: T
authors.lastname: Simons
authors.forename: Jonathon R B
authors.initials: JR
authors.lastname: Halbesleben
authors.forename: Deirdre
authors.initials: D
authors.lastname: McCaughey
authors.forename: Grant T
authors.initials: GT
authors.lastname: Savage
authors.forename: Luc
authors.initials: L
authors.lastname: Sels
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001530:Belgium; D006801:Humans; D007857:Leadership; D015233:Models, Statistical; D009741:Nursing Staff, Hospital / Q000941:ethics / Q000331:legislation & jurisprudence / Q000592:standards*; D010348:Patient Care Team / Q000941:ethics / Q000331:legislation & jurisprudence / Q000592:standards*; D061214:Patient Safety / Q000331:legislation & jurisprudence / Q000592:standards*