The association of leadership qualification and leadership quality -a quantitative secondary analysis from Switzerland

While leadership quality is a key factor for retention in healthcare, it remains unclear whether formal leadership qualifications are associated with leadership quality in practice. This study examined the association between leadership qualifications and leadership quality, while jointly considering employees' and leaders' working conditions in Switzerland. This cross-sectional secondary analysis included 1,942 employees and 118 leaders from 22 healthcare organizations. Leadership quality and psychosocial job demands and resources were assessed using COPSOQ and EWCS scales. Linear mixed-effects models were estimated to examine associations. Leadership qualifications were not associated with perceived leadership quality. In contrast, several employee-reported job demands and resources were associated with leadership quality. Higher quantitative (B = −0.41) and emotional demands (B = −0.12), insecurity of the working environment (B = −0.27), and unfair behaviour (B = −0.07) were associated with lower leadership quality, whereas social support (B = 0.56) and rewards (B = 0.16) were positively associated (all p < .001). Leaders' own job demands were not associated with perceived leadership quality. The findings suggest that leadership quality in healthcare is shaped more by employees' working conditions than by formal leadership qualifications. Improving leadership quality therefore requires addressing organizational and psychosocial work environments alongside individual leadership development.