The purpose of this study is to investigate the existence of a patient safety chain for hospitals. Drawing on high reliability organization theory, multifactor leadership theory and total quality management literature, we develop and test a model for improving patient safety – a critical issue facing hospitals today. Specifically, we hypothesize that improving patient safety begins at the highest level of the organization with a transformational leadership style. This leads to a sequence of linkages whereby transformational leadership has an important relationship with creating a culture of safety, which in turn is associated with the adoption of patient safety initiatives, and ultimately with positive improvements in patient safety outcomes. Using data from a nationwide survey of over 200 hospitals, we use structural equation modeling to provide empirical support for the effectiveness of this patient safety chain model. The results have major implications for enhancing operations in hospital settings.

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This study examines the critical impact of human resource factors on the competitive advantage of supply chain management (SCM) practices. The human resource management (HRM) literature suggests that there are effects of HRM factors on SCM success, but neglects the relative importance among various factors regarding organizational performance. Survey responses from executives in 358 of the largest US manufacturing and service corporations are analyzed to test the relationships among selected HRM factors and SCM practice success. The results suggest an interactive role of managerial and employee support to enhance the effectiveness of employee training and to mitigate the adverse effect of implementation barriers on the success of SCM practices. The corresponding implications for managerial practice are also discussed in terms of the use of HRM program implementation to create a sustainable competitive advantage even when competitors adopt similar SCM “best practices”.

The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

This exploratory study examines healthcare quality program practices, employee commitment and control initiatives, and perceived results by surveying the directors of hospital quality programs. U.S. hospitals are renowned to be among the highest in quality, but recent studies assert that the majority of error-related deaths per year are preventable. In response, healthcare organizations have adopted quality management programs. Employee commitment and control theories propose that employee initiatives are critical to patient safety. However, little research has focused on the efficacy of employee commitment and control initiatives for quality programs at healthcare organizations. This study examines the responses from Quality and Risk Directors of 372 U.S. hospitals. The results of structural equation modeling (SEM) demonstrate that perceived quantitative and qualitative quality program results are more highly related to employee commitment and control initiatives than they are related to quality practices. #