Influence of Nursing Leadership, Decision Making, and Management Skills on the Quality of Patient Outcomes in Hospitals

• Padilla Hartigan

  Author

Patient outcomes in hospitals are directly related to the framework of skills and competencies, along with the nursing professionals in charge of leadership, decision-making, and management. Despite the focus of previous research on the constituent of clinical skills and expertise, comparatively fewer have focused on the nursing leadership and managerial practice integration pertaining to patient safety, recovery time, and patient satisfaction. The present study proposes the new Nursing Leadership–Decision–Outcome (NLDO) framework on nursing which gives the first structured approach to assess the integration of leadership styles, decision-making systems, and managerial competencies in influencing patient outcomes. This framework consists of three layers: (i) attitudinal evaluation of the leader on the basis of the validated behavioral scales, (ii) focused analyses on clinical and administrative decision-making, and (iii) impact analytics on nursing outcomes, such as decreased mortality and readmission, along with patient-reported experiences and outcomes on the nursing activities in the hospital. Mixed-methods outcome evaluation was used which involved quantitative analyses from outcome data of 12 hospitals along with qualitative interviews with 145 nurses and 60 patients. The results indicate that transformational leadership along with pathways of evidence-based decision-making and rational management practice have the strongest positive relationships with patient and nurse care coordination, medication safety improvement, and overall patient satisfaction. Discharge efficiency improved significantly among hospitals that utilized the NLDO framework, achieving a 17% reduction in avoidable complications. This study improves the literature by presenting a replicable model that systematically connects nursing leadership actions to real-world patient outcomes. As a vision that integrates management and leadership capabilities as fundamental factors that influence the quality of care, the research empowers hospital leaders, policymakers, and nursing faculty focused on advancing patient-centered care.

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