Effect of transformational leadership on job satisfaction and patient safety outcomes

Published:October 25, 2017DOI:


      • Nursing leadership is pivotal to providing high-quality patient care and ensuring favorable organizational outcomes.
      • Transformational leadership indirectly influences nurses' job satisfaction and prevalence of adverse patient outcomes through workplace empowerment.
      • Managers who demonstrate transformational leadership in the workplace have greater potential to create environments that support professional nursing practice that promote high-quality patient care.
      • Health care administrators need to consider change of policies to improve the work environment by providing leadership development and mentorship opportunities for existing and aspiring managers.



      Improving patient safety within health care organizations requires effective leadership at all levels.


      The objective of this study was to investigate the effects of nurse managers' transformational leadership behaviors on job satisfaction and patient safety outcomes.


      A random sample of acute care nurses in Ontario (N = 378) completed the crosssectional survey. Hypothesized model was tested using structural equation modeling.


      The model fit the data acceptably. Transformational leadership had a strong positive influence on workplace empowerment, which in turn increased nurses' job satisfaction and decreased the frequency of adverse patient outcomes. Subsequently, job satisfaction was related to lower adverse events.


      The findings provide support for managers' use of transformational leadership behaviors as a useful strategy in creating workplace conditions that promote better safety outcomes for patients and nurses.


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