The present study examines the influence of leadership, employee involvement and Green Lean Six Sigma (GLSS) on the quality improvement of patient safety in specialised hospitals. This study also investigates the mediating roles of GLSS and employee involvement in the relationship between leadership and the improvement in patient safety quality.

In this study, a stratified random sampling technique was applied to collect data from 384 respondents of specialised hospitals in Bangladesh. SmartPLS 4 was employed to assess construct reliability and validity and to test mediation effects via bootstrapping. Furthermore, hypotheses were tested via partial least squares structural equation modelling (PLS-SEM).

The study’s findings indicate that leadership, employee involvement and GLSS have a positive and significant influence on the quality of patient safety. Based on the results, employee involvement has the greatest impact on quality and patient safety improvement compared to leadership and GLSS. However, the research findings also indicate that leadership does not directly influence the quality improvement of patient safety but does so indirectly through the mediating effects of GLSS and employee involvement.

This study provides important insights into how healthcare practitioners can enhance patient safety outcomes through effective leadership and operational activities. The results are informative regarding the management of specialised hospitals. The findings may serve as a reference point for the evaluation of GLSS and for the ecological sustainability of hospital management practices in developed and developing countries.

This study offers theoretical and practical contributions, and it is anticipated that the research findings will generate ideas to improve patient safety and quality in healthcare organisations.