Participative leadership in healthcare: Which situational contextual factors influence managers’ decision to involve employees?

Abstract

Today’s technological and societal developments are creating new possibilities for designing an economical, flexible and human-oriented work organization e.g. by facilitating more agile management concepts. Research has been concerned with participative leadership styles for many decades, and these have recently been gaining renewed relevance in meeting the demands placed on leadership in modern management settings. Therefore, existing concepts of participative leadership need to be put to test for today’s work organization.An established concept of participative leadership is the model by Vroom (2000, based on Vroom & Yetton, 1973 and Vroom & Jago, 1988), which distinguishes between different degrees of employee participation in decision-making processes depending on situational contextual factors. Empirical studies show that managers who use a participative decision-making style consistent with the model by Vroom have more productive and satisfied employees as well as higher decision quality (e.g. Paul & Ebadi, 1989, Pasewark & Strawser, 1994). Because this model outlines clear implications for employee participation in decision-making based on if-then operations, it can help young managers in particular to structure decision-making processes and to reflect on how to involve employees depending on specific situational contextual factors.As in other sectors, healthcare is affected by the challenges of today's work organization. As far as leadership is concerned, managers usually learn leadership behavior implicitly and there is a high demand of leadership development and the teaching of useful leadership models (McAlearney, 2006). Therefore, this study focuses on the application of the model on employee participation in decision-making processes in healthcare context and poses the following research question: Which situational contextual factors influence managers’ decision to involve employees?As a first step, literature and semi-structured interviews with healthcare managers were used to identify relevant situational contextual factors in decision-making for healthcare: time pressure, information availability, employee acceptance, employee expertise and employee engagement.In a second step, assumptions about the degree of participation depending on given situational factors in healthcare were formulated, based on empirical findings on the model by Vroom.In a third step, healthcare managers (N=30) were asked to complete a questionnaire indicating what level of participation they would choose for different combinations of the given situational contextual factors in decision-making. Following assumptions regarding participation depending on situational contextual factors were confirmed by the healthcare managers: -If there is time pressure, the manager would make decisions without employee participation. -If employee acceptance is important, there would be a group decision-making process. -If an employee has more knowledge or expertise on a decision problem than the manager, the person would be involved in the decision-making process. -If employees share the organization's goals, they can participate in the decision-making process.The findings show consistency with the decision-making model by Vroom and support the relevance of participative leadership in healthcare. Possibilities for the next step of developing a decision tree that links situational factors with if-then operations and lead to a recommended level of employee participation in decision-making processes in the healthcare context are discussed.