The impact of leadership and quality climate on hospital performance

Objective. To explore the relationship between leadership effectiveness and health-care trust performance, taking into account external quality measures and the number of patient complaints; also, to examine the role of care quality climate as a mediator. Design. We developed scales for rating leadership effectiveness and care quality climate. We then drew upon UK national indices of health-care trust performance—Commission for Health Improvement star ratings, Clinical Governance Review ratings and the number of patient complaints per thousand. We conducted statistical analysis to examine any significant relationships between predictor and outcome variables. Setting. The study is based on 86 hospital trusts run by the National Health Service (NHS) in the UK. The data collection is part of an annual staff survey commissioned by the NHS to explore the quality of working life. Participants. A total of 17 949 employees were randomly surveyed (41% of the total sample). Results. Leadership effectiveness is associated with higher Clinical Governance Review ratings and Commission for Health Improvement star ratings for our sample (ß = 0.42, P < 0.05; ß = 0.37, P < 0.05, respectively), and lower patient complaints (ß = –0.57, P < 0.05). In addition, 98% of the relationship between leadership and patient complaints is explained by care quality climate. Conclusions. Results offer insight into how non-clinical leadership may foster performance outcomes for health-care organizations. A frequently neglected area—patient complaints—may be a valid measure to consider when assessing leadership and quality in a health-care context.

Leadership in American Evangelical churches:an explanatory theory

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT This study is about leadership in American Evangelical Churches, which as a sub-set of American Christianity, are growing, while American Christianity as a whole is in decline. As a result evangelicalism is quickly becoming the dominate iteration of American Christianity. It is anecdotal that well led churches grow while poorly led churches do not, yet no one has identified what leadership, in the evangelical church context, is. Researchers have investigated a number of aspects of church leadership (much of it without identifying whether or not the churches under investigation were evangelical or not) but no one has put forth a unified theory linking these aspects together. The purpose of this research is to address that gap and develop a theory that explains how evangelicals view leadership in their local churches. In this study of three churches, dissimilar in size and governance, a purely qualitative approach to data collection and analysis was employed. The study involved 60 interviews that sought points-of-view from top and mid-level leadership along with congregant followers. The study borrowed heavily from Glaser and Strauss (1967) Grounded Theory approach to data analysis. The results developed a theory which provides a unified explanation of how leadership actually works in the three evangelical churches. Several implications for practice are discussed as to the theory's usefulness as a method of leadership education and evaluation. An original discovery was found that an individual's incumbency within the organization was identified as a social power. Limitations to this research are the limitations generally imputed to purely qualitative research in that questions are raised about the theory's applicability to evangelical churches beyond the three studied. The suggestions for further research involve addressing those limitations

Pathways to leadership:board independence, diversity, and the emerging pipeline in the US for women directors

In the wake of this decade's corporate scandals, crimes and excesses, improving the effectiveness of corporate governance in the United States has become a priority. An important influence on a board's effectiveness at monitoring is its members’ degree of independence from senior management. While the current definition of independence revolves around the absence of familial and economic connections between a firm and its directors, research suggests that this standard may be inadequate in ensuring independent oversight. Rather, diversity along racial, gender and other dimensions has been proposed as a potentially more effective standard for board independence. This is especially welcome news for women, who currently comprise 51 per cent of the US managerial workforce but only 14.8 per cent of the directors on boards of large, publicly traded US corporations. Some explain the current dearth of women board members by claiming that there are no qualified women available for board service and/or that women are not interested in board service. However, there is more anecdotal rather than empirical evidence on the issue. Surveying women at a women's leadership conference in Boston, this research investigates the extent to which women are currently involved in some type of board service and the extent to which women aspire to future board service. We find that women are currently more active in governance activities than prior research on corporate boards suggests and that they aspire to play a continued and expanded role in governance activities.