Sentinel events and safety-specific leadership in the relationship between burnout and safety behaviors among healthcare workers: A moderated mediation study

This study aims to examine whether sentinel events experienced by healthcare workers, such as workplace injuries, moderate the relationship between burnout and safety behaviors. Additionally, by addressing this link between burnout and safety, this study investigates safety-specific leadership as a resource for sustaining safety standards in high-pressure healthcare environments. A cross-sectional survey was conducted among hospital personnel (N = 763), collecting data on burnout, sentinel events, safety-specific leadership, and safety behaviors. Moderation and mediation analyses were performed using structural equation modeling. Results showed that burnout was negatively associated with safety-specific leadership (β = −.42, p < .001), which was positively related to safety compliance (β = .36, p < .001) and safety participation (β = .33, p < .001), indicating a partial mediation. The indirect effects of burnout on safety behaviors via leadership were significant across all levels of sentinel events. These effects strengthened as the frequency of sentinel events increased. These findings highlight the role of safety-specific leadership in healthcare to reduce the detrimental impact of burnout on safety practices. This study provides novel insights into how leadership can intervene in the relationship between burnout and safety outcomes, offering implications for improving patient and worker safety.