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Abstract The merit and influence of effective leadership has become far more acknowledged and wide spread in healthcare administration. As it plays many important roles in the healthcare organizations such as shaping the healthcare organization’s culture, enhancing the patient safety, and improving the quality of care. There are many leadership styles that leaders demonstrate to lead such as transactional and transformational styles. Each leadership style has a different effect on the roles of leaders. The study aims to: 7. To determine the leadership styles among all personnel holding managerial positions in the study hospitals. 8. To assess the leadership styles among all personnel holding managerial position as perceived by their followers working in the study hospitals. 9. To determine the organizational culture among the study hospitals. 10. To identify patient safety initiatives. 11. To assess quality of care in terms of generic quality indicators. 12. To measure the association between leadership styles, organizational culture, patient safety initiatives, and quality of care. The study was conducted at the inpatient of the six general governmental hospitals in the State of Kuwait. The study sample consisted of: e. Leaders: All hospital directors and heads of departments (66 leaders). f. Followers: - All heads of departments (60 leaders). - A sample of those who were under the supervision of hospitals leaders (271 employees). g. Incident reports: All incident reports for one year period. h. Generic quality indicators: All statistics on generic quality indicators in each studied hospital for one year period. Data was collected as follows: III. Cross-sectional: Three self-administered questionnaires were used: - Multifactor Leadership Questionnaire (leader form): filled by the leaders to determine their leadership styles. - Multifactor Leadership Questionnaire (rater form): filled by the followers to determine leadership styles of their leaders. - Organizational Description Questionnaire: to determine the organizational culture. - Patient Safety Questionnaire: to assess the reporting practice and the implementation of patient safety initiatives. Summary 98 IV. Retrospectively: - Review of incident reports for one year period in order to assess the reporting practices. - Review of statistical reports of five generic quality indicators for one year period to assess the quality of care. The data was analyzed using computer with statistical Package for Social Sciences version 15.0 and suitable statistical methods. The study reveals the following findings: 30. Leadership style of hospitals’ leaders in the six studied hospitals according to both self-rating and followers’ rating is mostly of transformational style. 31. There are discrepancies between self-rating and followers’ rating where the leaders rated themselves as transformational style higher than their followers. 32. The relationship between the transformational leadership style and the demographic and work-related characteristics of both hospitals’ directors and heads of departments are not statistically significant. 33. Organizational culture in the six studied hospitals is mostly of transformational according to followers’ rating. 34. A large percentages ranging from 60.5% to 80.4% of followers rated their leader as well as organizational culture as transformational style. 35. Although the followers rated both transformational and transactional leadership styles as having poor reporting practices in most of the studied hospitals, most of the percentages of poor practice with transformational leadership style is less than that with transactional leadership style. 36. Although the followers rated both transformational and transactional leadership styles as having poor implementation of patient safety initiatives in most studied hospitals, most of the percentage of poor implementation with transformational leadership style is less than that with transactional leadership style. 37. There are indirect and non-significant relationship between generic quality indicators and transformational leadership style of both hospitals’ directors and heads of departments. Based on the previous findings, the following is recommended: 4. Disseminate the results of the present study to Kuwait Minister of Health in order to clarify the importance of: a. Transformational leadership style and its effect on healthcare services. b. Openness, communication, and transparency between leaders and followers. 5. At level of Ministry of Health: f. Designing training programs on regular basis for hospitals’ directors and heads of departments to improve transformational leadership behavior and empower the concept of transformational organizational culture. g. Recruiting leaders in healthcare services must be conditioned by obtaining a certificate in leadership. h. Encouraging leaders sharing governance and provide them with the authority needed to support them in practicing transformational leadership role. i. Greater investment in research is needed to understand how to build transformational leaders and how can it be more effective on organizational outcome, patient safety, and quality of care. j. Further studies are required to include other healthcare organizations such as primary and tertiary healthcare facilities. 6. At level of hospital: Conduct a workshop and courses by researcher in each studied hospitals in order to explore the effect of transformational leadership style on organizational outcomes, patient safety, and quality of care |