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The Impact of Adaptive Leadership Capacity on Complex Organizational Health Systems Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2017 The mpI act of Adaptive Leadership Capacity on Complex Organizational Health Systems Outcomes Laura Lentenbrink Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Medicine and Health Sciences Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Laura Lentenbrink has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Jeff Snodgrass, Committee Chairperson, Health Services Faculty Dr. Vasileios Margaritis, Committee Member, Health Services Faculty Dr. Mehdi Agha, University Reviewer, Health Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2017 Abstract The Impact of Adaptive Leadership Capacity on Complex Organizational Health Systems Outcomes by Laura M. Lentenbrink JD, Cooley Law School, 1991 MS-N, Andrews University 1984 BSN, Nazareth College, 1973 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University May 2017 Abstract Nonlinear and chaotic environmental changes characterize health services organizations as complex adaptive systems in which leaders must exercise non-traditional leadership practices to succeed. Health services leaders who have learned and implemented traditional linear management approaches are ill prepared to lead in complex environments. This study tested complexity and adaptive leadership theories of agility and resilience in complex health systems. The purpose of this quantitative cross-sectional internet-based survey study was to quantify relationships between independent variables of agility and resilience and secondary dependent variables of financial, patient satisfaction, quality and human capital outcomes. The impact of turbulence was also examined. Included sample data were collected from 533 employed healthcare leaders using probability-based systematic proportional random sampling methods and were analyzed through correlation, regression, one-way analysis of variance, t tests, and Hayes PROCESS statistical analytics. Agility correlated with and predicted patient satisfaction outcomes. Resilience independently correlated with and predicted financial performance and patient satisfaction outcomes and augmented the correlation and predictability of agility. Agility and resilience cumulatively predicted financial performance outcomes. Turbulence was related to agility, resilience, financial performance, and patient care quality outcomes and mediated relationships with financial and patient care quality outcomes. Health services leaders may apply these findings to promote social change through the implementation of the agile and resilient leadership approaches necessary to achieve organizational performance outcomes that benefit vulnerable populations. The Impact of Adaptive Leadership Capacity on Complex Organizational Health Systems Outcomes by Laura M. Lentenbrink JD, Cooley Law School, 1991 MS-N. Andrews University, 1984 BSN, Nazareth College, 1973 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Services Walden University May 2017 May, 2017 Dedication This dissertation is dedicated with humble appreciation to my husband Tom, son Bryan, and daughter Jennifer in recognition of their unwavering support, tolerance, patience, and encouragement throughout my educational and dissertation journey. Acknowledgements The most significant lesson learned during the dissertation process is that successful completion is dependent upon a community of expertise, action and support. While this dissertation is a product of a community rather than solitary process, individual recognition of all contributing individuals is beyond the scope of this acknowledgement. Examples include the hundreds of health services leaders who contributed their valuable time and insights through completion of the internet survey for this study and the individuals who willingly provided secondary organizational dependent data outcomes. However, individuals who merit specific acknowledgement exist. I would like to express my sincere thanks to Mr. Mike Hall and Mr. Dan Mondoux who willingly provided technical support and advice upon request irrespective of the time. The outstanding sample size representing multiple levels of leaders throughout the United States would not have been attained without the unwavering time, sponsorship and support of my organizational sponsor. As a member of my dissertation committee, Dr. Susan Nyanzi provided expertise and advice that strengthened the caliber and substance of this dissertation. As an additional dissertation committee member, Dr. Vasileios Margaritis provided time and valued feedback that enhanced the professional quality of this dissertation. Also appreciated was the time provided by the committee URR, Dr. Mehdi Agha. Of special note is the expertise, time, advice and patience persistently shared by my dissertation chairperson, Dr. Jeff Snodgrass who served as an impactful model and advisor. Completion of this dissertation would not have been possible without his guidance. Finally, many thanks to my husband Tom for his compassion and support and unwavering belief that accomplishment of this dissertation was feasible during the times when completion seemed far beyond my reach. Table of Contents List of Tables .................................................................................................................... vii List of Figures ......................................................................................................................x Chapter 1: Introduction to the Study ....................................................................................1 Introduction ....................................................................................................................1 Background of the Study ...............................................................................................2 Problem Statement .........................................................................................................4 Purpose of the Study ......................................................................................................5 Research Questions and Hypotheses .............................................................................6 Theoretical Framework ................................................................................................10 Nature of the Study ......................................................................................................14 Definition of Terms......................................................................................................16 Assumptions .................................................................................................................20 Limitations ...................................................................................................................21 Scope and Delimitations ..............................................................................................22 Significance of the Study .............................................................................................23 Summary and Transition ..............................................................................................24 Chapter 2: Literature Review .............................................................................................26 Introduction ..................................................................................................................26 Problem ................................................................................................................. 26 Purpose .................................................................................................................. 27 Overview: Chapter Content and Literature Synopsis .......................................... 28 i Literature Search Strategy............................................................................................29 Theoretical Foundation ................................................................................................30 Literature Review Related to Key Concepts and Variables .........................................35 The Health Care Services Environment ................................................................ 35 Turbulence ............................................................................................................ 42 Complex Adaptive Systems .................................................................................. 44 Traditional Leadership Theory and Practices ....................................................... 53 Complexity Leadership ......................................................................................... 64 Adaptive Capacity ................................................................................................
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