The relationship between leader support, staff influence over decision making, work pressure and patient satisfaction: a cross-sectional analysis of NHS datasets in England

Thomas West, Pascale Daher, Jeremy Dawson, Joanne Lyubovnikova, Sandra Buttigieg, Michael West

Research output: Contribution to journalArticle (Academic Journal)peer-review

10 Citations (Scopus)
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Abstract


Objective: To explore the relationships between leader support, staff influence over decisions, work pressure and patient satisfaction.

Design: A cross-sectional study of large National Health Service (NHS) datasets in England in 2010.

Setting and participants
: 158 NHS acute hospital trusts in England (n=63 156) from all staff groups.

Primary and secondary outcome measures: Survey data measuring leader support, staff influence over decision making, staff work pressure and objective outcome data measuring patient satisfaction.

Results: Multilevel serial mediation analysis showed a significantly positive association between leader support and staff influence over decisions (B=0.74, SE=0.07, p<0.01). Furthermore, staff influence over decisions showed a negative association with staff work pressure (B=−0.84, SE=0.41, p<0.05) which in turn was negatively linked to patient satisfaction (B=−17.50, SE=4.34, p<0.01). Serial mediation showed a positive indirect effect of leader support on patient satisfaction via staff influence over decisions and work pressure (B=10.96, SE=5.55, p<0.05).

Conclusions and implications
: Our results provide evidence that leader support influences patient satisfaction through shaping staff experience, particularly staff influence over decisions and work pressure. Patients’ care is dependent on the health, well-being, and effectiveness of the NHS workforce. That, in turn, is determined by the extent to which leaders are supportive in ensuring that work environments are managed in a way which protects the well-being of staff.
Original languageEnglish
Article numbere052778
JournalBMJ Open
Volume12
Issue number2
Early online date1 Feb 2022
DOIs
Publication statusPublished - 2 Feb 2022

Bibliographical note

Publisher Copyright:
© 2022 BMJ Publishing Group. All rights reserved.

Keywords

  • Leadership
  • Healthcare
  • Autonomy
  • Work pressure
  • Patient satisfaction

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