Abstract
BACKGROUND: Occupational Health and Safety (OHS) is a critical concern in healthcare settings, particularly in resource-constrained environments where safety challenges often compromise staff well-being and patient care. Effective leadership and quality management are increasingly recognized as essential for addressing these challenges. OBJECTIVE: This study investigates the impact of Strategic Leadership (SL) on the Occupational Health and Safety System (OHS) in hospitals, with Total Quality Management (TQM) serving as a mediating factor. Utilizing a cross-sectional survey design. METHODOLOGY: Data were collected from 323 healthcare professionals across six hospitals in Hodeida, Yemen, covering both medical and administrative roles. Partial Least-Squares Structural Equation Modeling (PLS-SEM) was employed to analyze the data, examining both direct and indirect relationships among the study variables. RESULTS: The findings reveal that SL positively influences OHS directly and indirectly through TQM. Specifically, leadership practices that emphasize strategic direction, ethical conduct, and organizational control contribute to fostering a safer work environment. TQM enhances this effect by strengthening operational efficiencies and standardizing safety protocols. These results underscore the critical role of integrated leadership and quality management in advancing OHS practices in resource-constrained healthcare settings. CONCLUSION: The study offers practical implications for hospital administrators seeking to improve safety and performance through a combined focus on leadership and quality management. Future research should explore these dynamics in different sectors and geographical contexts to validate and extend these findings.