Quality leadership, technology integration and patient care quality across countries: moderating roles of national culture and infrastructure development

Purpose To better understand the nature and effective delivery of quality health-care globally, this paper aims to study the role of quality leadership on patient care quality (PCQ) delivered in hospitals, including the intervening role of technology integration and two country-level factors – national culture and infrastructure development – in North America (Canada, Mexico and the USA). Design/methodology/approach PCQ comprises four facets: interpersonal, technical, environmental and administrative quality. Using survey data and interdisciplinary theoretical support (e.g. quality management and the Global Leadership and Organizational Behavior Effectiveness Project [GLOBE] model of national culture), this paper tested for moderated mediation between hospital quality leadership and the four-facet PCQ model with technology integration as the mediator and national culture and infrastructure development as moderators. Findings Results show that technology integration partially mediates the relationship between hospital quality leadership and PCQ and that national culture and infrastructure development shape the role of hospital quality leadership on PCQ. Hence, these national factors must be considered holistically to understand the impact of hospital quality leadership on patient care. Practical implications To improve PCQ, hospital leaders should broaden their understanding of quality health-care to include technology integration and an awareness of cultural and institutional differences across nations. Originality/value This paper used primary data from hospital quality leaders and the four-facet PCQ conceptualization across three large North American nations, offering a more global understanding of service quality in health-care.