What's in a leader? Association of perceived leadership effectiveness and psychological safety among clinical physician faculty.

Objective: To identify leadership qualities associated with psychological safety among physician faculty in a large medical centre in New York City.

Patients and methods: An anonymous, institution-wide cross-sectional survey was sent to all physician faculty with clinical responsibilities between July and September 2022. Demographic and occupational characteristics were assessed. Perceived leadership effectiveness was measured with the nine-item Mayo Leadership Index and psychological safety was measured using the seven-item Fearless Organisation Questionnaire. Multivariable logistic regression analyses were conducted to determine associations between leadership, psychological safety, and demographic and occupational correlates of psychological safety.

Results: Of 3086 eligible clinical faculty members, 867 (28.1%) physicians with clinical responsibilities participated. On average, 57.6% of physicians reported that their workplace was psychologically safe and the majority agreed with items on the Mayo Leadership Index (60.0%-84.5%), the most prevalent being 'treats me with respect and dignity,' 'employs me to do my job' and 'encourages employees to suggest ideas for improvement.' In a multivariable model, higher overall leadership index scores were positively associated with psychological safety scores.

Conclusions: Greater perceived leadership effectiveness was positively associated with psychological safety among clinical physician faculty at a large, urban hospital. These results suggest that organisational investment in promoting leadership effectiveness may have positive downstream effects on healthcare delivery, burn-out and attrition rates.