Patient safety culture is an important component of hospital quality and safe healthcare delivery. This study aimed to determine the effects of clinical leadership and intrinsic motivation on patient safety culture through effective communication as a mediating variable among healthcare workers in the outpatient unit of Mandaya Puri Hospital. This was a quantitative explanatory study with a cross-sectional design involving 110 doctors and nurses selected using total sampling. Data were collected using a four-point Likert questionnaire and analyzed using partial least squares structural equation modeling (PLS-SEM) with SmartPLS. Descriptive analysis used the Three-Box Method. All variables were categorized as high: clinical leadership 85.94, intrinsic motivation 87.80, effective communication 84.63, and patient safety culture 86.21. The structural model explained 97.4% of the variance in patient safety culture (R²=0.974) and 94.6% of the variance in effective communication (R²=0.946). Clinical leadership significantly affected effective communication (β=0.912; p<0.001) and patient safety culture (β=0.282; p=0.026). Effective communication significantly affected patient safety culture (β=0.421; p<0.001), while intrinsic motivation significantly affected patient safety culture (β=0.296; p=0.001) but not effective communication (β=0.062; p=0.588). Effective communication partially mediated the effect of clinical leadership on patient safety culture (β=0.384; VAF=57.66%), but did not mediate the effect of intrinsic motivation (β=0.026; p=0.625; VAF=8.07%). These findings indicate that strengthening clinical leadership, intrinsic motivation, and effective communication is important for improving patient safety culture
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