The Role of Safety Culture, Clinical Leadership Capacity, and Teamwork

Rika Rika (Universitas Kristen Krida Wacana, Jakarta)
Hery Winoto Tj (Universitas Kristen Krida Wacana, Jakarta)

Global Academy of Business Studies
Vol. 2 No. 3 (2026): January

Purpose: This study aims to examine the effects of patient safety culture and clinical leadership capacity on nurses’ incident reporting compliance, with teamwork tested as a mediating mechanism. Research methodology: A census survey was conducted among 204 nurses at Sentra Medika Hospital Cikarang. Data were collected using a structured questionnaire comprising 18 validated indicators and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Results: The results indicate that patient safety culture has a significant positive effect on both incident reporting compliance and teamwork. Clinical leadership capacity also demonstrates significant positive effects on teamwork and reporting compliance. Notably, teamwork shows a significant negative direct effect on incident reporting compliance, suggesting a preference for informal, team-based problem resolution that may substitute for formal reporting processes. However, teamwork significantly mediates the relationships between patient safety culture, clinical leadership capacity, and reporting compliance. Conclusions: The findings highlight a paradoxical role of teamwork in patient safety. While collaborative environments are essential, they must be strategically aligned with non-punitive and transparent reporting systems. Strengthening patient safety culture and clinical leadership, while institutionalizing team practices that reinforce formal reporting, is essential to enhance sustainable patient safety performance. Limitations: The study is limited to a specific hospital setting and may not be generalizable to all healthcare environments. Additionally, the study relies on self-reported data, which may introduce bias. Contributions: This study contributes to the understanding of how patient safety culture, clinical leadership capacity, and teamwork interact to influence incident reporting compliance in hospitals, emphasizing the need for a balanced approach that integrates both formal reporting systems and collaborative team practices.