Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2017 Leadership among Directors of Social Services at Rehabilitative Healthcare Chains John Paul Tuanqui Abenojarj Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Health and Medical Administration 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 JohnPaul Abenojar 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. Cheryl Cullen, Committee Chairperson, Health Services Faculty Dr. Kimberly Dixon-Lawson, Committee Member, Health Services Faculty Dr. Vincent Agboto, University Reviewer, Health Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2017 Abstract Leadership among Directors of Social Services at Rehabilitative Healthcare Chains by John Paul T. Abenojar MSW, University of Michigan, 2005 BS, San Diego State University, 2003 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Healthcare Administration Walden University July 2017 Abstract Rehabilitation and healthcare centers (RHCs) provide ongoing care to the elderly and chronically ill. To maximize the quality of this care, RHC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, there is a substantial gap in the literature on the leadership styles and strategies employed by directors of social services (DSSs). The aim of this phenomenological study was to address this gap in the research by exploring how DSSs influenced leadership policies, prepared subordinates for crisis intervention and management, perceived that social workers influenced decision-making in patient care, and believed that communication amongst RHC staff about patient care could be improved. The conceptual framework for this study was based on 3 leadership model constructs: the multilevel leadership model construct, the situational leadership model construct, and the complex adaptive leadership model construct. Participants included a purposive sample of 10 DSSs working in large, corporate RHCs in Virginia. Data were collected via in-person, semistructured interviews consisting of open-ended questions. Data were analyzed via Hycner’s phenomenological approach. Findings from this investigation helped clarify roles and responsibilities of DSSs, thereby improving the leadership they provide to subordinate social workers. Findings may be used to improve communication across professionals within RHCs and emphasize the important role that social workers should play in patient care decisions. Leadership among Directors of Social Services at Rehabilitative Healthcare Chains by John Paul T. Abenojar MSW, University of Michigan, 2005 BS, San Diego State University, 2003 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Healthcare Administration Walden University July 2017 Dedication I dedicate my dissertation to all the social workers around the country who work with elderly populations, as well as all the seniors I have met and who taught me valuable life lessons. I also dedicate this work to the People of Barrio Napo. A special feeling of gratitude to my late and loving grandparents, Tomas and Pilar, for watching and guiding me from above throughout this journey. I also dedicate this dissertation work to my greatest mentors, the late Dr. Riz Oades, who served as my first mentor. To Dr. Isidro Ortiz for believing in me and for always being there to guide me and encourage me along the way. To Veronica Bejar, who introduced me to the McNair Scholars program, which helped convince me to pursue my doctoral degree, no matter what it took. And lastly, to the love of my life, Eugene S. Bebis, for always being there for me and for inspiring me. Acknowledgements First and foremost I would like to thank my family, relatives, friends and co- workers for your love, encouragement and support throughout this journey. I would like to thank my committee chair, Dr. Cheryl Cullen, for her mentorship, guidance, and helpful feedback throughout the process. To my committee member, Dr. Kimberly Dixon-Lawson, for her guidance and feedback. To Dr. Vincent Agboto, who served as the University research reviewer, I thank you. Lastly, to God be the Glory Table of Contents List of Tables ..................................................................................................................... vi List of Figures ................................................................................................................... vii Chapter 1: Introduction ...................................................................................................... 1 Introduction ..................................................................................................................... 1 Background ..................................................................................................................... 2 Problem Statement .......................................................................................................... 3 Purpose of the Study ....................................................................................................... 5 Guiding Questions .......................................................................................................... 5 Conceptual Framework ................................................................................................... 6 Nature of the Study ......................................................................................................... 7 Definitions....................................................................................................................... 9 Assumptions .................................................................................................................. 12 Scope and Delimitations ............................................................................................... 12 Limitations .................................................................................................................... 12 Significance of the Study .............................................................................................. 13 Summary ....................................................................................................................... 13 Chapter 2: Literature Review ........................................................................................... 15 Introduction ................................................................................................................... 15 Literature Search Strategy............................................................................................. 17 Leadership Studies ........................................................................................................ 18 i Context-Free Leadership ............................................................................................... 20 Context-Specific Leadership Styles .......................................................................... 24 Conceptual Framework ................................................................................................. 26 The Multilevel Leadership Model Construct ............................................................ 27 The Situational Leadership Model Construct ........................................................... 29 Complex Adaptive Leadership Model Construct ..................................................... 30 Rationale for Selection of these Models ................................................................... 31 Key Variables and/or Concepts .................................................................................... 32 The Routine Management Construct ........................................................................ 33 The Developing Crisis Management Construct ........................................................ 33 The Crisis Management Leadership Construct ......................................................... 34 Methodological Literature ............................................................................................ 35 RHC Leadership............................................................................................................ 35 Organizational Structure of RHCs ............................................................................ 37 Operational Characteristics of RHCs ........................................................................ 39 RHC Treatment Models ............................................................................................ 45 Medicare, Medicaid, and RHCs ................................................................................ 47 Staff Functions .............................................................................................................