Literature Review: The Effect of Transformational Leadership Style on Hospital Patient Safety Culture
Article Sidebar
Abstract:
Background of study: Patient safety culture is essential for achieving high-quality safe services. Transformational leadership plays a significant role in shaping a work environment that supports safety.
Aims and scope of paper: This review aims to identify the forms of transformational leadership and its impact on patient safety culture in hospitals.
Method: This study uses a literature review method with a systematic approach based on PICOT. Data were collected from six databases with criteria set for the years 2021-2025, using keywords 'Leadership Style', 'Patient Safety Culture', and 'Hospital', resulting in 10 journals that were analyzed. This study uses a literature review method with a systematic approach based on PICOT. Data were collected from six databases with criteria set for the years 2021-2025, using keywords 'Leadership Style', 'Patient Safety Culture', and 'Hospital', resulting in 10 journals that were analyzed
Results: From the screening results, 10 relevant articles were obtained and analyzed. The results of the analysis show that transformational leadership style has a positive impact on patient safety culture through motivation, role modeling, and individual attention. However, its implementation is still hampered by low incident reporting and weak communication. Safety culture also acts as a mediator between leadership and clinical safety practices.
Conclusion: This literature review emphasizes that the application of transformational leadership is effective in strengthening patient safety culture. Team support, staff knowledge, and an open reporting system are essential for realizing a sustainable safety culture.
Keywords: Leadership Style, Patient Safety, Transformational
Copyright (c) 2025 Ummiya Ummiya, Alpan Habibi

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Astuti, N. P., Santos, O. S. C. Dos, Indah, E. S., & Pirena, E. (2021). Upaya Pencegahan Pasien Resiko Jatuh dalam Pelaksanaan Asuhan Keperawatan di Rumah Sakit. Jurnal Manajemen Asuhan Keperawatan, 5(2), 81–89. https://doi.org/10.33655/mak.v5i2.117
Dharmawan, S., Pamungkas, R. A., & Hilmy, M. R. (2024). Effect of Leadership Style and Patient Safety Culture on Awareness Patient Safety Incident Reporting with Teamwork Perception as Intervening at X Cancer Hospital Jakarta. Buletin Penelitian Kesehatan, 52(2), 54–64. https://doi.org/10.33860/bpk.v52i2.3999
Dyah, A. W., Nugroho, N., & Just, I. (2024). The Influence of Knowledge and Leadership on Clinical Risk Management with Patient Safety Culture as an Intervening Variable at PMI Hospital. Jurnal Mahasiswa Ilmu Farmasi Dan Kesehatan, 2(4), 216–235. https://doi.org/10.59841/jumkes.v2i4.1859
Fitriana, D., Mahfud, M., Putri, I. R. R., & Fatimah, F. S. (2023). Pengaruh Gaya Kepemimpinan terhadap Kinerja Perawat dalam Keselamatan Pasien Di Unit Rawat Inap RSUD Penembahan Senopati. Jurnal Manajemen Kesehatan Indonesia, 11(2), 166–174. https://doi.org/10.14710/jmki.11.2.2023.166-174
Habibi, A., Giyanti, U., & Sriningsih, N. (2019). Hubungan Gaya Kepemimpinan Kepala Ruangan Dan Motivasi Kerja Dengan Kinerja Perawat Di Ruang Rawat Inap RS AN-NISA Tangerang Alpan. Jurnal Ilmiah Keperawatan Indonesia, 2(2), 65–80. http://jurnal.umt.ac.id/index.php/jik/index 65
Habibi, A., Humairoh, S., Ahmad, S. N. A., Hasan, R., & Nurfadillah, N. (2021). Hubungan Reward Dengan Kinerja Perawat Di Rumah Sakit Dr. Sitanala Tahun 2020. Jurnal JKFT, 6(2), 73. https://doi.org/10.31000/jkft.v6i2.5757
Hamdan, M., Jaaffar, A. H., Khraisat, O., Issa, M. R., & Jarrar, M. (2024). The Association of Transformational Leadership on Safety Practices Among Nurses: The Mediating Role of Patient Safety Culture. Risk Management and Healthcare Policy, 17(June), 1687–1700. https://doi.org/10.2147/RMHP.S458505
Hernawati. (2021). Pengaruh Sikap terhadap Kepatuhan Perawat pada Penerapan Budaya Keselamatan Pasien di RS Mitra Sejati. Jurnal Health Sains, 2(5), 604–620. https://doi.org/10.46799/jhs.v2i5.160
Hult, M., Terkamo-Moisio, A., Kaakinen, P., Karki, S., Nurmeksela, A., Palonen, M., Peltonen, L. M., & Häggman-Laitila, A. (2023). Relationships between nursing leadership and organizational, staff and patient outcomes: A systematic review of reviews. Nursing Open, 10(9), 5920–5936. https://doi.org/10.1002/nop2.1876
Irianto, H. P., Ramadhan, Y., & Saptaningsih, A. B. (2025). Pengaruh Kepemimpinan Transformasional, Kerjasama Tim, Dan Pengetahuan Terhadap Budaya Keselamatan Pasien Di Rsud Menggala Lampung. Journal of Nursing and Public Health, 13(1), 90–104. https://doi.org/10.37676/jnph.v13i1.8491
Marselina, E. V. (2023). Dimensi Budaya Keselamatan Pasien dan Insiden Keselamatan Pasien di RS X Kota Malang Elystia Vidia Marselina. Jurnal Penelitian Kesehatan Forikes, 14(2), 275–279. https://doi.org/10.33846/sf14208
Mulyatiningsih, S., & Sasyari, U. (2021). Gaya Kepemimpinan yang Efektif dalam Meningkatkan Keselamatan Pasien. Jurnal Ilmiah Keperawatan Altruistik, 4(1), 27–35. https://doi.org/10.48079/vol4.iss1.60
Nashifah, N. S., & Adriansyah, A. A. (2021). Analisis Pelaporan Insiden Keselamatan Pasien : Studi Kasus Di Rumah Sakit Islam Jemursari Surabaya. MOTORIK Jurnal Ilmu Kesehatan, 16(2), 50–55. https://doi.org/10.61902/motorik.v16i2.218
Patarru’, F., Nursalam, & HAS, E. M. M. (2020). Efektivitas Kepemimpinan Transformasional Terhadap Peningkatan Kinerja Perawat. Jurnal Penelitian Kesehatan Suara Forikes, 11(3), 381–384. https://doi.org/10.33846/sf11411
Pawerangi, M. H., Amang, B., & Nurpadila. (2023). Pengaruh Gaya Kepemimpinan Transformasional Dan Kepuasan Kerja Terhadap Kinerja Perawat Di Rumah Sakit Umum Lasinrang Kabupaten Pinrang. SEIKO : Journal of Management & Business, 6(1), 468–476. https://doi.org/10.37531/sejaman.v6i1.4406
Permenkes, R. (2017). Peraturan Menteri Kesehatan Republik Indonesia Nomor 11 Tahun 2017 Tentang Keselamatan Pasien. Jakarta: Kementerian Kesehatan RI. Google Scholar
Rizal, A. S., Mukhti, N., & Mu’allimin. (2024). Menjelajahi Makna Budaya Organisasi. Jurnal Ilmiah Kajian Multidisipliner, 8(5), 571–581. https://doi.org/10.57251/multiverse.v1i3.716
Rombeallo, N. T., Tahir, T., & Saleh, A. (2022). Faktor Penyebab Rendahnya Pelaporan Insiden Keselamatan Pasien di Rumah Sakit: Literature Review. Jurnal Keperawatan, 14(53), 657–666. Google Scholar
Seljemo, C., Viksveen, P., & Ree, E. (2020). The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: a cross-sectional study. BMC Health Services Research, 20(1), 1–9. https://doi.org/10.1186/s12913-020-05671-y
Sidika, K., Merve, B. G., Buse, M., Zeliha, A., Hande, M. A., Saadet, A., & Nursel, T. (2023). Patient Safety Culture: Effects on Errors, Incident Reporting, and Patient Safety Grade. Journal of Patient Safety, 19(7), 439–446. https://doi.org/10.1097/PTS.0000000000001152
Soliha, S., Mufidah, N., & Abdillah, A. (2021). Hubungan Antara Gaya Kepemimpinan Dengan Budaya Keselamatan Pasien Di Irna a Rsud Syarifah Ambami Rato Ebu Bangkalan. NURSING UPDATE : Jurnal Ilmiah Ilmu Keperawatan P-ISSN : 2085-5931 e-ISSN : 2623-2871, 12(1), 94–103. https://doi.org/10.36089/nu.v12i1.1106
Suparjo, D., & Paramarta, V. (2025). Pengaruh Gaya Kepemimpinan , Kerja Tim dan Budaya Keselamatan Pasien terhadap Pencapaian Sasaran Keselamatan Pasien ( Patient Safety ) di Rumah Sakit Umum Daerah Majalengka. AKADEMIKA: Jurnal Mahasiswa Ekonomi & Bisnis, 5(2), 660–674. https://doi.org/10.37481/jmeb.v5i2.1321
Suwoto, S., Mutiara, R., & Kemala, R. (2024). The Influence of Leadership Style and Cognitive Attitudes on Patient Safety Culture With Coordination as a Moderation Variable in Inpatient Nurses at Tzu Chi Hospital. VitaMedica: Jurnal Rumpun Kesehatan Umum, 2(4), 29–49. https://doi.org/10.62027/vitamedica.v2i4.182
Torar, R. H., & Wulandari, C. I. (2023). Pengaruh Gaya Kepemimpinan Transformasional kepala Ruang terhadap Implementasi Budaya Keselamatan Pasien di RS. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 6(8), 1545–1553. https://doi.org/10.56338/mppki.v6i8.3669
Turang, J. R., Tilaaar, R. J. N., & Kurniawati, H. (2025). Budaya Keselamatan Pasien di Rumah Sakit. In Komite Mutu RSUD Anuntaloko Parigi. Google Scholar
Umrana, S., Sarwadhamana, R. J., Priskila, E., Utami, A. S., Mitra, D., Carolina, P., & Juniasti, H. T. (2024). Manajemen dan Kepemimpinan Dalam Keperawatan. Eureka Media Aksara. Google Scholar
Wahyudyasa, P. T. J., Hasyim, H., & Kusumapradja, R. (2023). Transformational Leadership Styles and Mentoring Functions Towards a Culture of Patient Safety Moderated by Competence of the Nurse at Metro Hospitals Cikarang. International Journal of Nursing and Health Services (IJNHS), 6(4), 225–231. https://doi.org/10.35654/ijnhs.v6i4.748
Widjaya, A. P., & Hidayah, N. (2022). The Effect of Effective Leadership on Nurse Performance in the Application of Patient Safety at Aji Muhammad Parikesit Hospital Tenggarong with Motivation and Workload as Intervening Variables. Ra Journal of Applied Research, 08(04), 250–255. https://doi.org/10.47191/rajar/v8i4.05