Empowering Leadership and Mindfulness in Health Care Improvement Teams: A Multilevel Analysis

Thesis Overview

The study advanced team learning literature by: (a) explaining the role of the leader’s empowering leadership style in the team learning process and (b) studying improvement teams in the complex dynamic setting of the health care industry.

This study used a multilevel structured equation model approach (MSEM) to analyze a model design that proposes relationships between team leader empowering behaviors, team psychological safety, team improvement activities and improvement implementation. Ample data was collected from six different health care organizations, including 62 improvement teams, and 407 employees and leaders. Findings from this analysis provide valuable insights for academics and industry managers.

The results demonstrated that empowering leadership behaviors are positively associated with team psychological safety and the successful implementation of improvements. They also showed that
psychological safety mediates the relationship between empowering leaders and successful implementation of improvements. Additionally, team mindfulness moderation is supported at the
within-level only, which is interpreted as psychological safety having a stronger effect on improvement activities when team members display higher levels of team mindfulness. Finally, no evidence was found on the role of team leader mindfulness in the team learning framework proposed by this research.

Managerial Summary

Today's health care environment in the U.S. is rapidly changing. This has forced organizations to quickly adopt new practices while improving the quality of care. As a result, a new paradigm of value-based performance has been developed wherein health care providers deliver improved outcomes at reduced costs. This has led to an accelerated pace of change that requires organizations to develop capabilities to promote environments where employees proactively mitigate errors and solve problems. To accomplish this, health care organizations are relying on small- to mediumsized teams to lead and improve processes. This in turn requires competent leaders to ensure success.

The learning behaviors presented in this research are guided by improvement activities aligned with the Toyota Production System. The fi ndings in this research demonstrated that empowering leadership behaviors are needed to positively infl uence the team learning process and improvement results. Leaders are crucial to implement lean principles and methods, to design structures that support lean improvement methods, and to demonstrate behaviors that promote employee coaching for improvement activities. The study underlined that a high level of team mindfulness accelerates the likelihood of effective process improvement during lean improvement activities.

Business leaders can no longer depend on existing knowledge and skills to run their operations without problems. The nature of health care requires the evaluation of every operation on a continuous basis in order to cope with process issues and external demands. The fi ndings of this study indicate that even in a rapidly changing environment, team learning and team mindfulness are important to discover problems and implement changes. To achieve the successful implementation of change a leader's mindset has to emulate empowering behaviors that encourage employees to share their expertise and voice their concerns.

Key Points

• Findings demonstrate that the payoffs of market orientation development can only be perceived in the latest stages of development.
• Organizations must be willing to progress from one stage of development to the next without necessarily seeing the benefits
• The researcher created the fi rst quantitative scale to help organizations monitor the implementation of market orientation.
• Used quantitative testing to confi rm the grounded theory model of how market orientation is developed and implemented.