Abstract
Purpose. The key problem that this dissertation deals with is that no validated evidence exists to support or challenge the proposition that leadership is a requirement for the effective implementation of a QI initiative, as asserted by many quality experts. The context for investigating this problem is organizational transformation in the healthcare industry—specifically in general, acute hospitals with at least one hundred licensed beds. It is the purpose of this research to examine and, as clearly as possible, (1) identify correlations between hospital quality leadership attributes and the implementation of QI initiatives; (2) describe the configuration of hospital quality leadership teams; (3) identify the role of the quality champion in hospitals; and (4) identify the relationship between leadership and organizational quality climate, as well as organizational quality climate and QI implementation. Methodology. A survey methodology was utilized in this descriptive correlational and exploratory study which was conducted to examine hospital quality leadership. Two survey instruments were received from a convenience sample of eleven qualifying hospitals: (a) the Leadership Practices Inventory (LPI), and (b) the Quality Improvement Implementation Survey (QIIS). The instruments were completed by organizational members who were members of the quality leadership team. Hospital and leader demographic questionnaires were also completed by the CEO/designee and the respondents respectively. Findings. (1) Although some significant relationships between measures on these instruments were identified using Pearson product-moment correlations, the results of three tests were equivocal. The LPI-Self scores were negatively correlated with the QIIS scores (n.s.). The LPI-Observer and composite LPI-Self plus Observer scores were not significantly correlated. A correlation between the QIIS leadership criterion and other QIIS criteria was statistically significant, lending some support to the importance of leadership for QI implementation. Additionally, the LPI practice, enabling others to act, was more strongly correlated with the seven QIIS factors than the other four LPI practices. (2) Three styles of quality leadership team configurations were identified: entirely administrative, administrative/managerial, and administrative/managerial/workforce. None of these styles was significantly correlated to the QIIS scores. (3) The role and importance of the quality champion was not well established. Individuals could be recognized as champions, but the presence of these champions was not significantly correlated with higher QIIS scores. (4) Finally, the organizational climate was found not to be significantly correlated with leadership scores, but significantly correlated with quality improvement implementation scores. Conclusions and recommendations. Leadership may be correlated with some aspects of quality improvement implementation. However, quality leadership in hospitals remains a poorly understood concept. A major shortcoming of this study was the small sample that participated in the research. Although envisioned as a much larger study, only 11 hospitals participated in all aspects of the study. The findings indicated a wide range of opportunities for further important research. Similar research in other industries, utilizing the same and alternative measures, and examining other key factors for QI implementation were suggested. Validated findings may specifically be of assistance to healthcare consultants, OD professionals, business schools, and organizational leaders who desire to influence the positive implementation of their quality improvement system.