Safety Performance as a Mechanism Linking Leadership and Work Facilities to Healthcare Workers’ Performance: The Moderating Role of Communication Transparency

Abstract

Objective: To examine the direct effects of leadership and work facilities on healthcare workers’ performance, the mediating roles of safety awareness and safety performance, and the moderating role of communication transparency in a resource-constrained regional hospital.
Methods: A sequential explanatory mixed-method design was applied at Dr. L.M. Baharuddin Regional General Hospital, Muna Regency, Indonesia. The quantitative phase involved 144 respondents drawn from a population of 225 healthcare workers. Data were collected using Likert-scale questionnaires and analyzed with partial least squares structural equation modeling. Qualitative information from selected participants was used to contextualize the quantitative findings.
Results: Leadership significantly predicted safety performance (β=0.294; p=0.019) but not safety awareness or healthcare workers’ performance. Facilities significantly predicted safety awareness (β=0.823; p<0.001), safety performance (β=0.593; p<0.001), and healthcare workers’ performance (β=-0.277; p=0.048). Safety awareness (β=0.223; p=0.041) and safety performance (β=0.418; p=0.001) predicted performance. Safety performance mediated the facilities-performance relationship (β=0.248; p=0.001). Communication transparency moderated the effects of leadership, facilities, and safety performance on healthcare workers’ performance.
Conclusion: Healthcare workers’ performance is shaped by the interaction of organizational resources, safety behavior, and transparent communication. Strengthening facilities and safety performance while maintaining open communication may improve performance in resource-constrained hospitals.