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Collaborating with nurse leaders to develop patient safety practices

Anne Kanerva (Central Finland Health Care District, Jyvaskyla, Finland)
Tuula Kivinen (Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland)
Johanna Lammintakanen (Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 3 July 2017




The organisational level and leadership development are crucial elements in advancing patient safety, because patient safety weaknesses are often caused by system failures. However, little is known about how frontline leader and director teams can be supported to develop patient safety practices. The purpose of this study is to describe the patient safety development process carried out by nursing leaders and directors. The research questions were: how the chosen development areas progressed in six months’ time and how nursing leaders view the participatory development process.


Participatory action research was used to engage frontline nursing leaders and directors into developing patient safety practices. Semi-structured group interviews (N = 10) were used in data collection at the end of a six-month action cycle, and data were analysed using content analysis.


The participatory development process enhanced collaboration and gave leaders insights into patient safety as a part of the hospital system and their role in advancing it. The chosen development areas advanced to different extents, with the greatest improvements in those areas with simple guidelines to follow and in which the leaders were most participative. The features of high-reliability organisation were moderately identified in the nursing leaders’ actions and views. For example, acting as a change agent to implement patient safety practices was challenging. Participatory methods can be used to support leaders into advancing patient safety. However, it is important that the participants are familiar with the method, and there are enough facilitators to steer development processes.


Research brings more knowledge of how leaders can increase their effectiveness in advancing patient safety and promoting high-reliability organisation features in the healthcare organisation.



Kanerva, A., Kivinen, T. and Lammintakanen, J. (2017), "Collaborating with nurse leaders to develop patient safety practices", Leadership in Health Services, Vol. 30 No. 3, pp. 249-262.



Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited

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