Improving patient care through leadership engagement with frontline staff: a Department of Veterans Affairs case study.
Singer SJ, Rivard PE, Hayes JE, Shokeen P, Gaba D, Rosen A. Jt Comm J Qual Patient Saf. 2013;39:349-360.
A program to engage frontline workers with management in addressing safety issues at the unit level paradoxically resulted in worse perceptions of safety culture. Although leadership involvement is critical to augment patient safety, this article indicates that simply increasing engagement does not always yield productive improvement efforts.