Can leadership reduce errors and patient safety within radiology services?

Abstract

Background: Radiology presents risks to patient safety such as ionising radiation and magnetic fields. Despite legislation, guidance and standard procedures, errors still occur which are linked to human and organisational factors. Leadership as a concept can potentially influence patient safety by creating the optimum environment and behaviours. The literature exploring how leadership can reduce errors and improve safety within radiology is limited. The aim of the review was to evaluate the evidence on how leadership practices and behaviours can influence errors and patient safety within radiology.

Methods: A systematic review study was undertaken according to PRISMA guidelines. Five databases were searched (including CINAHL, Psychinfo, Pubmed, Publicly Available Content Database - Proquest and Scopus) for evidence from the last 10 years (2015 – 2025). Inclusion criteria included primary quantitative and qualitative research studies that examined leadership and safety within healthcare environments (not solely radiology). Quality assessment of studies was performed utilising CASP checklists.

Results: 17 studies were included within the review (quantitative and qualitative studies, mostly cross sectional in design and one quasi-experimental study). Main findings showed that leadership positively influences patient safety directly and indirectly via various behaviours and mechanisms.

Conclusion: Leadership positively influences patient safety directly, or indirectly, via mechanisms such as organisational commitment, psychological safety and cooperation facilitation. Leaders should undertake leadership training, and leadership should not focus on a specific style but should incorporate behaviours that create a positive safety culture environment including support, training and education, clarifying expectations, open communication and non-punitive approaches to incidents.