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Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects


  • Dückers, Michel L.A.
  • Stegeman, Inge
  • Spreeuwenberg, Peter
  • Wagner, Cordula
  • Sanders, Karin
  • Groenewegen, Peter P.


Objectives The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation, between the extent to which physicians notice their CEOs stimulate improvement initiatives and the number of projects joined by physicians, is moderated by the consensus among physicians working in the same hospital.Methods Multilevel analyses are applied on data of 286 physicians from eight hospitals to: (1) estimate whether participation depends on noticing if CEOs stimulate improvement, (2) test if an individual's participation differs when more colleagues have the same opinion (effect modification).Results Significant moderator effects are found. The participation of physicians, noticing that CEOs stimulate improvement is higher when more colleagues share this opinion. For physicians not knowing whether improvement is encouraged, higher consensus coincides with lower participation.Conclusion Project involvement of physicians depends on their consensus about encouragement by CEOs. This confirms the importance of strategic leaders in dissemination programs. Further research is recommended into causes of CEO leadership visibility and methods to strengthen leadership climate.

Suggested Citation

  • Dückers, Michel L.A. & Stegeman, Inge & Spreeuwenberg, Peter & Wagner, Cordula & Sanders, Karin & Groenewegen, Peter P., 2009. "Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects," Health Policy, Elsevier, vol. 91(3), pages 306-313, August.
  • Handle: RePEc:eee:hepoli:v:91:y:2009:i:3:p:306-313

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    References listed on IDEAS

    1. M Patterson & P Warr & M West, 2004. "Organizational Climate and Company Productivity: the Role of Employee Affect and Employee Level," CEP Discussion Papers dp0626, Centre for Economic Performance, LSE.
    2. Luc Dorenbosch & Renee de Reuver & Karin Sanders, 2006. "Getting the HR Message Across: The Linkage between Line ? HR Consensus and "Commitment Strength" among Hospital Employees," management revue. Socio-economic Studies, Rainer Hampp Verlag, vol. 17(3), pages 274-291.
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    Cited by:

    1. Botje, Daan & Klazinga, Niek S. & Wagner, Cordula, 2013. "To what degree is the governance of Dutch hospitals orientated towards quality in care? Does this really affect performance?," Health Policy, Elsevier, vol. 113(1), pages 134-141.


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