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The literature on leader-member exchange theory (LMX) has consistently demonstrated the positive relationship between member perceptions of the quality of their relationship with the leader and member performance. The process through which relationship quality influences member performance, however, is still not fully understood. The present study provides an explanatory mechanism for this process. Specifically, feedback avoiding behavior, a feedback management strategy used by poor performers to minimize exposure to negative feedback from their leaders, fully mediates the relationship between LMX and member performance. Implications for theory and practice are discussed.

Purpose -The purpose of this case study was to gather participants' perceptions of the impact of Memorial Healthcare System's Pillars of Leadership Academy's leadership development programs on an individual, professional and organizational level. Design/methodology/approach -Through a mixture of in-person and telephone structured interviews, the researchers collected and analyzed qualitative data to explore the experiences of participants from the leadership development programs. Findings -The major themes that interviewees mentioned as impacts of their participation in the mentoring programs closely parallel the foundations of transformational leadership. This suggests that the goals of the Pillars of Leadership Academy have been successful in developing leaders, which provides the basis for improved organizational as well as individual performance. Practical implications -Developing leaders has been identified as one of the most pressing challenges for the future. Memorial Healthcare System (MHS) demonstrates that theory-and competency-based leadership development programs can contribute to the performance and success of individuals as well as health services organizations. Originality/value -The success of MHS overall and the contributions of the Pillars of Leadership Academy to the organizational culture and leadership provides a best practice that other organizations can follow regarding the implementation of a success leadership development program.

In today's environment of low reimbursement and high cost containment, health care managers need to focus on those items that will have the greatest impact on retaining high-quality nurses because nurses "make the critical, cost-effective difference in providing safe, high-quality patient care."

Efforts by hospitals to improve patient experience continue as changes in policy such as the Affordable Care Act of 2010 have made patient experience a cornerstone of promoting greater value in the United States. Hospital CEOs play an important role in promoting positive patient experiences as they set the organizational vision and strategic goals and can execute change to support positive experiences.This study assessed whether three CEO characteristics-education, tenure with the organization, and gender-were associated with patient experience scores of California hospitals in 2013 and 2014. Using a pooled, cross-sectional design with ordinary least squares regression to account for other hospital and market characteristics, the analysis indicated that hospitals with female CEOs and longer-tenured CEOs were associated with more positive patient experience scores. Higher levels of education were not significantly associated with patient experience scores. Overall, the model covariates accounted for approximately 14.0% of the variance in patient experience scores between hospitals, with CEO characteristics accounting for approximately 2.4% of this variation. Such findings highlight the important yet emerging role of CEO characteristics when accounting for patient experience.

Clinical practice guidelines can potentially lead to reductions in healthcare costs and improved patient outcomes if adopted by physicians into their clinical practice. This research study provides data that gives healthcare administrators a basic understanding of how physicians perceive clinical practice guidelines (CPGs) and gives practical suggestions to obtain physician adherence to CPGs.

EXECUTIVE SUMMARY An increasing number of lesbian, gay, bisexual, and transgender (LGBT) individuals openly acknowledge their identity; however, the fear of discrimination prevents many from seeking healthcare—an issue challenged by a lack of culturally competent LGBT healthcare providers. With more than 4% of American adults identifying as LGBT individuals, greater attention to their needs is imperative to improve care and access for this population. This study examined organizational and market factors associated with hospitals achieving the “Leader in LGBT Healthcare Equality” (Healthcare Equality Index, HEI; HEI Leader) designation and reported patient experience scores. We found that system-affiliated hospitals have 4.16 greater odds and teaching hospitals have 2.86 greater odds of earning the HEI Leader designation compared to nonsystem and nonteaching hospitals, respectively. Governmental hospitals have 2.47 greater odds of achieving HEI Leader status, while for-profit hospitals have 86% lower odds of having HEI Leader status compared to not-for-profit hospitals. Hospitals located in a metropolitan area have 3.19 greater odds of being an HEI Leader. The percentage of minorities and per capita income in a county also demonstrated a positive association with being an HEI Leader, with odds ratios of 1.00 and 1.02, respectively, while lower education was associated with 4% lower odds of being an HEI Leader. The main finding of this study was that HEI Leader-designated hospitals reported significantly higher overall hospital rating patient experience scores (B = 1.785; p ≤ .001) as compared to non-HEI Leader hospitals. As such, participation in the HEI may be viewed as a motivation for hospitals attaining HEI Leader designation.