Abstract
Background: Collective leadership theories suggest that shared responsibility and collaborative decision-making significantly enhance organizational performance by capitalizing on diverse experiences and fostering a culture of mutual accountability. This study evaluates the perceptions of senior hospital management regarding the impact of collective leadership within Senior Management Teams (SMTs) on patient safety, care quality and overall hospital performance across the 15 public hospitals in the eThekwini District.
Methods: A cross-sectional quantitative approach was employed to analyze the current operational state of public hospitals in the eThekwini District. The survey instrument demonstrated robust internal consistency (Cronbach's alpha > 0.70) for all primary constructs, ensuring reliable measures. Self-administered questionnaires, informed by a comprehensive literature review, assessed senior hospital management's understanding, experiences, and viewpoints on collective leadership. The study further explored the essential conditions for implementing collective leadership and its outcomes on patient safety, quality of care and hospital performance. Purposeful sampling targeted 69 members of senior management across 15 hospitals, guaranteeing a sample size adequate to achieve a 95% confidence level, 0.80 statistical power and a significance level of 0.05.
Results: A substantial portion of respondents indicated the practice of collective leadership within their organizations, fostering collaboration and shared decision-making. Positive correlations were observed between collective leadership practices and average scores for patient safety, quality of care and overall hospital performance. Independent t-tests revealed statistically significant disparities in patient safety and care quality between hospitals employing collective leadership and those that did not, with the former exhibiting higher mean scores. Chi-square tests indicated significant associations between collective leadership practices and categorical outcomes, including the implementation of team-based problem-solving strategies. Price-Related Differential (PRD) analysis suggested consistent evaluations of collective leadership’s influence across varying
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patient safety ratings, while the Coefficient of Dispersion (COD) underscored low variability in appraisals, highlighting potential areas for enhancement.
These findings accentuate the necessity of adopting collective leadership frameworks within healthcare environments to improve patient safety, quality of care and organizational performance. Moreover, the study emphasizes the need for contextually tailored leadership strategies that consider factors such as hospital size, organizational culture, hospital policies and management experience to optimize the advantages of collective leadership.
The findings indicate that senior management teams implementing collective leadership can enhance patient safety, quality of care and overall hospital performance within the public hospitals of the eThekwini District, even amidst incomplete establishment of all necessary conditions for collective leadership. Nonetheless, these improvements may exhibit variability compared to hospitals with fully integrated collective leadership frameworks.
Conclusion: The study concludes that collective leadership practices are positively associated with enhanced patient safety, quality of care and overall hospital performance.