The Role of Leadership in Improving Occupational Safety and Health (OSH) Culture in the Healthcare Services Sector
Keywords:
Occupational Health and Safety, Safety Culture, Leadership, Healthcare Sector, Safety ClimateAbstract
Occupational Safety and Health (OSH) culture is essential in ensuring the safety of healthcare workers, patients, and visitors, particularly in high-risk healthcare environments. Purpose: This study aims to analyze the role of leadership in improving OSH culture in the healthcare services sector. Methods: This study employed a qualitative approach using a systematic literature review (SLR) of peer-reviewed scientific journals and international guidelines related to leadership and OSH published between 2000 and 2025. Relevant sources were analyzed using a thematic approach to identify relationships between leadership practices and safety culture outcomes. Results: The findings indicate that leadership plays a critical role in shaping OSH culture through commitment, effective communication, policy enforcement, and employee engagement. Transformational and participative leadership styles significantly enhance safety awareness, compliance, and proactive safety behavior among healthcare workers. Implications: The results suggest that strengthening leadership capacity can improve safety performance, reduce workplace incidents, and support the development of a positive safety climate in healthcare organizations. Conclusion: Leadership is a key determinant in building a sustainable OSH culture, and healthcare institutions should prioritize leadership development to ensure continuous improvement in occupational safety and health.
References
Barling, J., Loughlin, C., & Kelloway, E. K. (2002). Development and Test of a Model Linking Safety-Specific Transformational Leadership and Occupational Safety. Journal of Applied Psychology, 87(3), 488–496. https://doi.org/10.1037/0021-9010.87.3.488
Braithwaite, J., Herkes, J., Ludlow, K., Testa, L., & Lamprell, G. (2017). Association Between Organisational and Workplace Cultures, And Patient Outcomes: Systematic review. BMJ Open, 7(11), e017708. https://doi.org/10.1136/bmjopen-2017-017708
Christian, M. S., Bradley, J. C., Wallace, J. C., & Burke, M. J. (2009). Workplace Safety: A Meta-Analysis of the Roles of Person and Situation Factors. Journal of Applied Psychology, 94(5), 1103–1127. https://doi.org/10.1037/a0016172
Clarke, S. (2013). Safety Leadership: A Meta-Analytic Review of Transformational and Transactional Leadership Styles as Antecedents of Safety Behaviours. Journal of Occupational and Organizational Psychology, 86(1), 22–49. https://doi.org/10.1111/j.2044-8325.2012.02064.x
Cooper, M. D. (2016). Navigating the Safety Culture Construct. Safety Science, 28(1), 1–14.
Dahlke, S., Hunter, K. F., Negrin, K., & Kalogirou, M. R. (2020). The Role of Leadership in Healthcare Safety Culture: A Scoping Review. Journal of Nursing Management, 28(6), 1184–1195. https://doi.org/10.1111/jonm.13074
Fan, D., Lo, C. K. Y., Ching, V., & Kan, C. W. (2014). Occupational Health and Safety Issues in Healthcare Sector. International Journal of Environmental Research and Public Health, 11(3), 3063–3079. https://doi.org/10.3390/ijerph110303063
Flin, R. (2007). Measuring Safety Culture in Healthcare: A Case for Accurate Diagnosis. Quality and Safety in Health Care, 16(6), 401–406. https://doi.org/10.1136/qshc.2007.021717
Guldenmund, F. W. (2010). Understanding and Exploring Safety Culture. Safety Science, 48(10), 1466–1477. https://doi.org/10.1016/j.ssci.2010.07.001
Hofmann, D. A., & Morgeson, F. P. (1999). Safety-Related Behavior as a Social Exchange: The Role of Perceived Organizational Support and Leader-Member Exchange. Journal of Applied Psychology, 84(2), 286–296. https://doi.org/10.1037/0021-9010.84.2.286
Katz, D., Green, E., & Johnson, T. (2019). Leadership Engagement and Workplace Safety Outcomes In Hospitals. Healthcare Management Review, 44(2), 123–131. https://doi.org/10.1097/HMR.0000000000000178
Kelloway, E. K., Mullen, J., & Francis, L. (2006). Divergent Effects of Transformational and Passive Leadership on Employee Safety. Journal of Occupational Health Psychology, 11(1), 76–86. https://doi.org/10.1037/1076-8998.11.1.76
Lee, S. E., & Scott, L. D. (2018). Hospital Leadership and Patient Safety Culture. Journal of Nursing Care Quality, 33(4), 319–326. https://doi.org/10.1097/NCQ.0000000000000318
Manapragada, A., & Bruk-Lee, V. (2016). Staying Safe While Working Safely: The role of safety climate. Journal of Occupational Health Psychology, 21(3), 343–355. https://doi.org/10.1037/a0039892
Morello, R. T., Lowthian, J. A., Barker, A. L., McGinnes, R., Dunt, D., & Brand, C. (2019). Strategies for Improving Patient Safety Culture in Hospitals. BMJ Open Quality, 8(3), e000582. https://doi.org/10.1136/bmjoq-2018-000582
Neal, A., & Griffin, M. A. (2006). Safety Climate and Safety Behavior. Australian Journal of Management, 31(2), 243–263. https://doi.org/10.1177/031289620603100202
Nielsen, K. J. (2014). Improving Safety Culture Through the Health and Safety Organization: A case study. Journal of Safety Research, 48, 7–17. https://doi.org/10.1016/j.jsr.2013.10.003
Occupational Safety and Health Administration. (2021). Recommended Practices for Safety and Health Programs. U.S. Department of Labor.
Reader, T. W., Noort, M. C., Shorrock, S., & Kirwan, B. (2014). Safety Culture in Healthcare Organizations. BMJ Quality & Safety, 24(1), 54–62. https://doi.org/10.1136/bmjqs-2013-001831
Reason, J. (2000). Human error: Models and Management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/bmj.320.7237.768
Ree, E., Wiig, S., & Braut, G. S. (2020). Leadership for Learning and Patient Safety Culture in Hospitals. BMC Health Services Research, 20(1), 1–10. https://doi.org/10.1186/s12913-020-4903-4
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in Healthcare: Key Discoveries Enabling Safer, High-Quality Care. American Psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298
Schein, E. H., & Schein, P. (2017). Organizational Culture and Leadership (5th ed.). Wiley.
Singer, S. J., Lin, S., Falwell, A., Gaba, D. M., & Baker, L. C. (2009). Relationship of Safety Climate and Safety Performance in Hospitals. Health Services Research, 44(2), 399–421. https://doi.org/10.1111/j.1475-6773.2008.00918.x
Vinodkumar, M. N., & Bhasi, M. (2010). Safety Management Practices and Safety Behaviour. Accident Analysis & Prevention, 42(6), 2082–2093. https://doi.org/10.1016/j.aap.2010.06.021
World Health Organization. (2020). Occupational Health and Safety in Public Health Emergencies. Geneva: World Health Organization.
World Health Organization. (2022). Global Patient Safety Action Plan 2021–2030: Towards Eliminating Avoidable Harm in Health Care. Geneva: World Health Organization.
Wu, T. C., Chen, C. H., & Li, C. C. (2008). A Correlation Among Safety Leadership, Safety Climate, and Safety Performance. Journal of Loss Prevention in the Process Industries, 21(3), 307–318. https://doi.org/10.1016/j.jlp.2007.11.001
Yousef, A. M., AbuAlRub, R., & Al-Maaitah, R. (2021). Leadership Styles and Safety Culture Among Nurses in Healthcare Organizations. Nursing Forum, 56(3), 540–547. https://doi.org/10.1111/nuf.12561
Zohar, D. (2010). Thirty Years of Safety Climate Research. Accident Analysis & Prevention, 42(5), 1517–1522. https://doi.org/10.1016/j.aap.2009.12.019
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Journal of Occupational Safety, Health, and Environmental Management (K3)
This work is licensed under a Creative Commons Attribution 4.0 International License.
