<p> Shared leadership paradigms are becoming more popular in organizations because of the increased responsibilities placed on leaders within health care organizations. Researchers have conducted little research on how individuals on leadership teams perceive their role in engaging with others in their team. The qualitative phenomenological hermeneutic study involved examining how radiology administrators in Northern California describe their lived experiences on shared leadership teams, with an emphasis on their perceptions of team productivity and trust. The conceptual framework for the study included shared leadership theory, which scholars have noted is still a new field of study. Seven research participants representing from three to 18 years of experience as radiology managers with experience serving on shared leadership teams. From the five initial questions and sub questions, the analysis involved breaking down the responses into 175 separate areas of exploration. In addition to the demographics of the groups and types of teams served on, four themes emerged from this data: lived experience on shared leadership teams, knowledge and skills learned from shared leadership teams, key factors affecting team performance on shared leadership teams, and the effect of diversity on shared leadership teams. The implications of the research to leadership are that radiology managers may gain a better understanding of when to use shared leadership and how to best staff the teams to support organizational work, and how to improve shared leadership team dynamics.</p>

<p>Hospital leaders who fail to respond to poor patient satisfaction reports may experience lower organizational performance. The purpose of this qualitative case study was to explore strategies of leaders in private health care settings to improve patient satisfaction. This study may provide strategies that health care leaders in the public setting can apply to improve patient satisfaction and organizational performance. One private health care provider operating in Vancouver, British Columbia, Calgary and Edmonton, Alberta, was selected as both private and public healthcare centers are located in these areas. Data were gathered from 12 participant interviews and from an examination of available physical artifacts such as organizational documents provided by the participants and the company website. Transformational leadership was the underlying conceptual framework for this research. Triangulation was used to ensure the rigorousness of the study. In the study, themes were identified after member checking the transcribed open-ended interview questions. The 5 themes identified were cohesive culture of employee engagement, patient-focused model of care, timely access and follow-up of results and coordination of care, continuous system quality improvement, and employee accountability. These themes underscore the importance of a culture of employee engagement; they also illuminate care that focuses on the patient-care that ensures timely access, follow-up and coordination of care, quality improvement based on patient feedback, and employee accountability. Current publicly-funded hospitals and health care centers may apply these findings to improve patient satisfaction and organizational performance. </p>

<p> This quantitative study was an evaluation of the effectiveness of the online Training Home software program, designed for use with a national nonprofit business model. This study was undertaken because nonprofits have a difficult time resourcing training. If the Training Home program can deliver a comprehensive training program for minimal cost, then a nonprofit will be better able to deliver on the nonprofit&rsquo;s stated mission. For this study, six research questions centered on measuring the helpfulness of the program, the difference in job function training, improved knowledge of a national nonprofit, and perception of the Training Home program between those that had and or had not used the program. Additionally, cost per unit of training, the number of training vignettes delivered, time spent in training, ease of use by supervisors, and staff ratings of the effectiveness of the training home program. The population studied was the 450 staff at one affiliate of the national nonprofit. This staff group consisted of a mix of genders, ages, and education levels. This study used archival data gathered over the 2013, 2014, and 2015 calendar years and was analyzed using multivariate regression and descriptive analyses. The cost and number of training vignettes delivered in a 24-month period were compared to determine whether the Training Home program was a more cost-effective delivery model than the prior system for the year before the study. Analyses indicate that the Training Home program delivered more training to staff at a lower cost per unit of training when compared to the units of training delivered in the prior model. Supervisors and staff reported the program to be effective in knowledge management and tracking and the training of all staff. The study had positive results for the sample studied. It would be beneficial for any future studies to expand the sample size into other geographic regions.</p><p>

<p> This study examines methods and barriers to minority leadership recruitment in healthcare organizations. Minorities are underrepresented in healthcare organizations at the executive level, even though staff and patient demographics are becoming increasingly diverse. This disparity in minority representation presents the potential for staff and patient needs, interests, and values to be overlooked by senior management and the strategies, policies, and programs they implement. This study conducted interviews with human resources personnel at healthcare organizations identified as top performers to determine whether their organizations engaged in minority recruitment methods, what methods were successful, and what barriers existed to recruitment of minorities. These results were compared to survey data compiled by the Institute for Diversity in Health Management. The results show significant room for improvement in the implementation of comprehensive methods to recruit minority senior management, with significant variation among organizations in the amount and type of methods to recruit minority executives. These findings lead to the conclusion that more pressure needs to be placed on healthcare organizations to identify best practices in minority recruitment and implement these in formal, comprehensive human resources activities related to recruitment, retention, and professional development.</p>

Thesis (Ph. D.)--University of Hawaii at Manoa, 2003. / Includes bibliographical references (leaves 67-77).

<p> <i><b>Context:</b></i> Evidence supports education initiatives to improve knowledge of sport-related concussion (SRC) in active children and adolescents, as well as improve attitudes towards reporting concussion events to a supervising adult with the ultimate goal of early diagnosis and management. Most evidence focuses on urban and suburban children&rsquo;s SRC knowledge and attitudes; however, little is known regarding knowledge and attitudes of children participating in sport in rural environments. Understanding current knowledge and attitudes of rural children can inform future education and health behavior strategies that encourage early reporting. <i><b> Objective:</b></i> Two objectives guided this study. First, obtain and analyze pilot data regarding current sport-concussion knowledge and attitudes from a rural youth cohort using a validated survey tool for adolescents. Secondly, make recommendations regarding the use of the tool and process to apply this method to a larger sample. <i><b>Design:</b></i> Survey Design. <i><b> Setting:</b></i> Middle and high school education setting. <i><b> Participants:</b></i> Twenty of 81 students who participated in interscholastic sport at a rural high school completed the survey for a response rate of 24.7%. More females (70%) than males (30%) completed the survey (<i>M</i>age = 15.0yrs, <i>SD</i> = 1.89; range 13&ndash;18 years). <i><b> Data Collection and Analysis:</b></i> Rosenbaum Concussion Knowledge and Attitudes Survey &ndash; Student Version (RoCKAS-ST). Main <i><b> Outcome Measure(s):</b></i> Self-reported &ldquo;likelihood to report&rdquo;, concussion knowledge index (CKI), and concussion attitude index (CAI). <i><b> Results:</b></i> Concussion knowledge (CKI) was high amongst all respondents (19.7/25) and related positively to concussion attitude towards safe environments (CAI = 60.5/75). Students also self-reported a strong likelihood to report a concussion (7.3/10). Age, sex nor participation in contact verses noncontact sports did not vary from this trend with one exception; football respondents reported the lowest likelihood to report regardless of having knowledge and a safe attitudes. <i><b>Conclusions:</b></i> Although no formal education strategy has been delivered to this small cohort, respondents demonstrated a high or acceptable level of SRC knowledge, attitude and likelihood to report. The RoCKAS-ST as well at the process for delivering the survey was generally sound, however, delivering the survey during baseline testing may improve response rate. Future research should investigate the knowledge and attitudes of a larger cohort of rural student-athletes and should include more details on where students are receiving their education. </p><p>

<p> This practicum sought to study whether the systematic creation of a set of Standard Operating Procedures (SOP) for the Department of Emergency Medicine (DEM) at University of Texas Southwestern (UTSW) would increase research staff confidence in their ability and improve knowledge of resources. We wished to determine also faculty confidence in research staff before and after SOP creation. The term SOP and its use came to prominence in the mid 20th century as a descriptor for a systematic method to ensure consistency and efficiency in task completion in organizations. An SOP is any document that seeks to standardize, through plain and instructive language, a common process or task in an organization to ensure the quality and uniformity of the outcome or product of said task or process. The DEM at UTSW was recently created as its own department when it split off from under the umbrella of the Department of Surgery and did not have any documented standardized processes in place regarding research administration actions and procedures. This could have been hindering the ability of the staff to operate efficiently, consistently, and correctly. For this project, the clinical research staff and faculty of the DEM of UTSW were surveyed regarding their confidence levels before and after a set of administrative SOPs was systematically developed to evaluate the success of the aforementioned SOPs. Before creating the SOPs, the staff and faculty were consulted on which SOPs they felt were most needed and, based upon the outcome of these consultations, creation of those SOPs was prioritized accordingly. Then, after looking at SOPs for similar or identical processes from other departments, they were collaboratively created with input and insights of research staff and faculty from these other departments. It was hypothesized that having SOPs would increase research staff confidence, increase efficiency, and increase accuracy in the completion of their duties, as well as increase faculty confidence in research staff. A statistical analysis of the seven pre-SOP research staff responses with six post-SOP research staff responses and 22 pre-SOP faculty responses with 15 post-SOP faculty responses yielded no significant associations. However, the mean response improved for all but one question of the faculty and research staff surveys. Considering the limitations of the present study, including a limited sample size and limited time window for completion, future studies with improved design are needed to further evaluate the impact of SOPs. But valuable, however, is the confirmation by the present study that involvement of personnel to whom SOPs apply is not only valuable and preferred, it is essential to ensuring that they are applicable and useful.</p><p>

This study analyzed the relationship between stressful work environments, physical fitness, and employee well-being, and proposed the “survival of the fittest” model. The “survival of the fittest” model was tested to determine whether physical fitness reduced the negative health outcomes of stressful work environments. Stressful work environments were framed through the job demands-control model (Karasek, 1979), and employee well-being was assessed through cardiovascular health and psychological well-being. Physical fitness was measured as cardiorespiratory endurance. Main effect and interaction effect models were tested using hierarchical regression and nonlinear structural equation modeling (SEM) analyses techniques. This study showed that employee well-being is negatively affected by current work trends. The results indicated that the interaction effect of high strain jobs (high job demands and low job control) negatively affected cardiovascular health, but not psychological well-being. Psychological well-being was negatively affected by high job demands, and low job control independently (main effects), whereas cardiovascular health was not negatively affected by these main effects. The results also indicated that fitness, when measured as a state, did not produce the hypothesized stress reducing effects, nor the expected improvements in cardiovascular health and psychological well-being. A discussion of these results includes an analysis of group differences, an evaluation of the fitness measure, and an examination of the sample population. This dissertation contributed to the occupational health and stress literature by offering conceptual and methodological improvements over past research. Specifically, I analyzed the job demands-control model through a focused measure of job control and a descriptive measure of job demands. Psychological well-being included the emotional exhaustion measure of burnout, and a measure of anxiety and depression not previously tested in this literature stream. Objective measures of cardiovascular health (blood pressure) and physical fitness (step test) were obtained, and data were gathered from a cross-sectional sample of 100 working adults. Furthermore, the application of nonlinear SEM techniques allowed for the simultaneous examination of physiological and psychological health outcomes, which provided a holistic view of the work stress and employee well-being relationship not previously found in this literature.

<p> Leadership is essential for the survival of the healthcare organization in the midst of challenging times due to health care reform and the public's desire for transparency and improved quality outcomes. Transformational leadership is desirable for nurse leaders in a rapidly changing environment, but nurse leaders are often challenged with the inability to meet the demands of this complex environment for a variety of reasons. The increasing competition for resources, both human and fiscal, leading to wider spans of control is one of those challenges. The purpose of this quantitative, correlational research study was to explore the relationship between span of control and the leadership style of nurse leaders. The setting for the study was a multi-facility healthcare system in the Midwest. Avolio and Bass' (2004) Multifactor Leadership Questionnaire Form 5X Short (MLQ) was utilized to determine the nurse leader's leadership style along the full range of leadership continuum. The span of control or number of direct reports each nurse leader had was collected along with other demographic data. </p><p> The Pearson product moment correlation was utilized to analyze the relationship between span of control and transformational leadership, and span of control and transactional leadership. The Spearman's rho correlation coefficient was utilized to analyze the relationship between span of control and passive/avoidant behavior. The data suggest that there is no relationship between span of control and the leadership style of nurse leaders. While no relationship was found, the findings remain significant to nurse leaders as they navigate the complex territory of healthcare and make strategic decisions about organizational structures.</p>

<p> Hospital performance metrics are an indicator of leadership performance. However, there is inadequate research on whether physician or nonphysician chief executive officers (CEOs) perform better in the U.S. hospitals. The purpose of this study was to examine which type of leaders is better. Leadership trait, situational leadership, and leadership behavior theories constituted the theoretical foundation. The key research question examined the relationship between a hospital&rsquo;s outcomes, which in this study, included hospital net income, patient experience ratings, and mortality rates, and the type of CEO in that hospital: physician or non-physician. A quantitative, causal comparative design was used to answer this question. Three hypotheses were tested using multivariate analysis of variance. The dependent variable was hospital outcomes: hospital net income, patient experience ratings, and mortality rates. The independent variable was the type of hospital CEO: physician and nonphysician. Datasets from 2014-2015 were used, which were publically available on the websites of U.S. based hospitals, research organizations, and journals. A sample of 60 hospitals was drawn from U.S. non-federal, short-term, acute care hospitals, based on number of staffed beds (<i>n</i> = 60). No significant differences were found between nonphysician and physician CEOs on hospitals&rsquo; net income (<i>p</i> = .911), patient experience ratings <i>(p</i> = .166), or mortality rates (<i> p</i> = .636). Thus, the null hypotheses were retained. Findings suggest that physician and non-physician CEOs may produce similar outcomes in the hospitals they lead. Based on these findings, hospital boards can view CEO applicants equally when considering whom to hire and understanding U.S. hospital leadership.</p>