Culture and Quality in Government General Hospitals in Kuwait: A Multimethod Study of their Association with the Transformational Leadership
Background Although there are many healthcare leaders and an ongoing quality programme in the national healthcare system in Kuwait, study of the relationship of leadership style to organisational culture and quality of care is lacking. Methods We report a multi-centre study that used cross-sectional and retrospective quantitative approaches in the government-sponsored secondary care setting in Kuwait. A sample of 1,626 was drawn from a frame of 9,863 physicians, nurses, and pharmacists in 6 general hospitals. Followers were surveyed using the Multifactor Leadership and the Organizational Description Questionnaires. We reviewed and analysed the past one year of quarterly and annual quality indicators of the studied hospitals. Data were analysed using Statistical Package for the Social Sciences (SPSS) Version 15.0. Results According to followers, 66.4% to 87.1% of participants in the six hospitals identified their hospital organisational culture as transformational, while 41 out of 48 departments were identified as having a transformational culture. The participants who rated their leader and organisational culture as transformational ranged from 60.5% to 80.4% in different hospitals, and 8.5% of participants in only 1 hospital scored their leader as transformational and their culture as transactional. The differences between leadership style and organizational culture were statistically significant for four hospitals. Regarding the quality indicators, there was an indirect non-significant correlation between a transformational leadership style and most hospitals' indicators. Conclusions Transformational leaders are definers and givers of culture. The prevailing transformational leadership style creates and maintains the kind of transformational organisational culture. Our work here indicates how a given leadership style affects statistics of indicators that reflect the quality of care delivery observed in hospitals. However, this relationship is statistically insignificant. This relationship needs further research.