Demeke Getnet Worku, van Engen Marloes L, Markos Solomon
Department of Business Administration and Information Systems, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Management, Kotebe University of Education, Addis Ababa, Ethiopia.
BMC Health Serv Res. 2025 Jul 28;25(1):984. doi: 10.1186/s12913-025-13118-5.
Healthcare systems continue to grapple with preventable patient safety challenges that require leadership interventions across all levels of operation. Servant leadership has emerged as a promising style for cultivating an organizational culture that promotes patient safety improvement within healthcare settings. This study explored how healthcare managers' servant leadership behaviors contribute to nurturing an organizational culture that boosts patient safety performance in public healthcare settings.
We conducted a multicenter qualitative case study to explore how healthcare managers' servant leadership nurtures a culture of patient safety in outpatient care settings of three large public sector hospitals in Addis Ababa, Ethiopia. Data were collected using in-depth interviews with 23 healthcare professionals (November 2023-March 2024) and onsite observations to generate rich, contextual insights about the research phenomenon. Template analysis, guided by the Ability‒Motivation‒Opportunity (AMO) framework, was used to explore the relationships between servant leadership and patient safety culture.
The research participants articulated their positive views about the patient safety practices of the respective public hospital outpatient care settings. The study produced key themes across the ability (supporting professional development, commitment to continuous learning), motivation (fostering a culture of service, providing incentives and rewards), and opportunity (promoting empowerment, leadership support, effective communication systems, resource allocation efforts, alignment of policies and systems) dimensions of human resources management.
Our study provides a comprehensive understanding of the leadership-safety culture phenomenon in Ethiopian public healthcare. The study critically unpacks how healthcare managers' servant leadership behaviors catalyze the cultivation of a patient safety culture through enhancing staff ability (e.g. continuous learning), inspiring motivation (e.g. service culture), and creating opportunities (e.g. resource provision) for engagement in safety-related initiatives. Integrating servant leadership with the AMO framework offers a powerful approach to nurturing an organizational culture that measurably enhances patient safety performance.
医疗保健系统仍在应对可预防的患者安全挑战，这需要在各级运营中进行领导力干预。仆人式领导已成为一种有前景的领导风格，有助于培育一种促进医疗保健环境中患者安全改善的组织文化。本研究探讨了医疗保健管理者的仆人式领导行为如何有助于培育一种提升公共医疗保健环境中患者安全绩效的组织文化。
我们进行了一项多中心定性案例研究，以探讨医疗保健管理者的仆人式领导如何在埃塞俄比亚亚的斯亚贝巴的三家大型公共部门医院的门诊护理环境中培育患者安全文化。通过对23名医疗保健专业人员进行深入访谈（2023年11月至2024年3月）并进行现场观察来收集数据，以生成有关该研究现象的丰富、情境化见解。在能力-动机-机会（AMO）框架的指导下，采用模板分析来探讨仆人式领导与患者安全文化之间的关系。
研究参与者阐述了他们对各自公立医院门诊护理环境中患者安全实践的积极看法。该研究在人力资源管理的能力（支持专业发展、致力于持续学习）、动机（培育服务文化、提供激励和奖励）和机会（促进赋权、领导支持、有效的沟通系统、资源分配努力、政策和系统的一致性）维度上产生了关键主题。
我们的研究提供了对埃塞俄比亚公共医疗保健中领导-安全文化现象的全面理解。该研究批判性地剖析了医疗保健管理者的仆人式领导行为如何通过提高员工能力（如持续学习）、激发动机（如服务文化）以及为参与安全相关举措创造机会（如资源提供）来催化患者安全文化的培育。将仆人式领导与AMO框架相结合，为培育一种可显著提升患者安全绩效的组织文化提供了一种有力方法。
