Healthcare leadership: cultures, climates and compassion

This chapter focuses on how leadership influences organizational culture in healthcare, drawing on international research and evidence from the English National Health Service (NHS). The first section defines culture and the associated concept of climate and how they are understood and measured. It describes key contextual factors that shape culture including emphasis on care, people management and teamworking. It then describes the research evidence on the influence of leadership on organizational climate and culture, before focusing particularly on safety cultures and climates. Research suggests a ‘value chain’ from leadership to staff engagement, care quality, patient satisfaction, care outcomes (including mortality) and financial performance. A seminal study of cultures of high-quality care in the English NHS reveals the centrality of leadership in the development of such cultures and the implementation of a healthcare culture change programme. Finally, the chapter focuses on the importance of compassion as a key cultural value in healthcare, describing research and theory pointing to compassionate leadership for ensuring high-quality care cultures.