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Assessing Leadership Behavior in Health Care: Introducing the Local Leadership Scale of the SCORE Survey.

Publication ,  Journal Article
Adair, KC; Levoy, E; Tawfik, DS; Palassof, S; Profit, J; Frankel, A; Leonard, M; Proulx, J; Sexton, JB
Published in: Jt Comm J Qual Patient Saf
March 2023

BACKGROUND: Engaged and accessible leadership is a key component of care excellence. However, the field lacks brief, reliable, and actionable measures of feedback and coaching-related behaviors of local leaders (for example, provides frequent feedback). The current study introduces a five-item Local Leadership (LL) scale by examining its psychometric properties, providing benchmarking across demographic factors and work settings, assessing its association with psychological safety, and testing whether LL predicts reports of restricted activities and absenteeism. METHODS: In this cross-sectional study, 23,853 questionnaires were distributed across 31 Midwestern US hospitals. The survey included the LL scale, as well as safety culture and well-being scales. Psychometric analyses (Cronbach's α, confirmatory factor analysis [CFA] fit: root square mean error of the approximation [RMSEA], comparative fit index [CFI], Tucker-Lewis index [TLI]), Spearman correlations, t-tests, and analyses of variance (ANOVAs) were used to test the properties of the LL scale and differences by health care worker and work setting characteristics. RESULTS: A total of 16,797 surveys were returned (70.4% response rate). The LL scale exhibited strong psychometric properties (Cronbach's α = 0.94; RMSEA = 0.079; CFI = 0.99; TLI = 0.98). LL scores differed by role, shift, shift length, and years in specialty. Of all roles, leaders (for example, managers) rated leaders most favorably. Nonclinical (vs. clinical) and nonsurgical (vs. surgical) work settings reported higher LL. LL scores correlated positively with psychological safety, absenteeism, and activities restricted due to illness. CONCLUSION: The LL scale exhibits strong psychometric properties, convergent validity with psychological safety, and variation by work setting, work setting type, role, shift, shift length, and specialty. The study indicates that assessing leadership behaviors with the LL scale is useful and offers actionable behaviors for leaders to improve safety culture within teams.

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Published In

Jt Comm J Qual Patient Saf

DOI

EISSN

1938-131X

Publication Date

March 2023

Volume

49

Issue

3

Start / End Page

166 / 173

Location

Netherlands

Related Subject Headings

  • Surveys and Questionnaires
  • Reproducibility of Results
  • Psychometrics
  • Leadership
  • Humans
  • Hospitals
  • General & Internal Medicine
  • Delivery of Health Care
  • Cross-Sectional Studies
  • 4203 Health services and systems
 

Citation

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Adair, K. C., Levoy, E., Tawfik, D. S., Palassof, S., Profit, J., Frankel, A., … Sexton, J. B. (2023). Assessing Leadership Behavior in Health Care: Introducing the Local Leadership Scale of the SCORE Survey. Jt Comm J Qual Patient Saf, 49(3), 166–173. https://doi.org/10.1016/j.jcjq.2022.12.007
Adair, Kathryn C., Emily Levoy, Daniel S. Tawfik, Sofia Palassof, Jochen Profit, Allan Frankel, Michael Leonard, Joshua Proulx, and J Bryan Sexton. “Assessing Leadership Behavior in Health Care: Introducing the Local Leadership Scale of the SCORE Survey.Jt Comm J Qual Patient Saf 49, no. 3 (March 2023): 166–73. https://doi.org/10.1016/j.jcjq.2022.12.007.
Adair KC, Levoy E, Tawfik DS, Palassof S, Profit J, Frankel A, et al. Assessing Leadership Behavior in Health Care: Introducing the Local Leadership Scale of the SCORE Survey. Jt Comm J Qual Patient Saf. 2023 Mar;49(3):166–73.
Adair, Kathryn C., et al. “Assessing Leadership Behavior in Health Care: Introducing the Local Leadership Scale of the SCORE Survey.Jt Comm J Qual Patient Saf, vol. 49, no. 3, Mar. 2023, pp. 166–73. Pubmed, doi:10.1016/j.jcjq.2022.12.007.
Adair KC, Levoy E, Tawfik DS, Palassof S, Profit J, Frankel A, Leonard M, Proulx J, Sexton JB. Assessing Leadership Behavior in Health Care: Introducing the Local Leadership Scale of the SCORE Survey. Jt Comm J Qual Patient Saf. 2023 Mar;49(3):166–173.

Published In

Jt Comm J Qual Patient Saf

DOI

EISSN

1938-131X

Publication Date

March 2023

Volume

49

Issue

3

Start / End Page

166 / 173

Location

Netherlands

Related Subject Headings

  • Surveys and Questionnaires
  • Reproducibility of Results
  • Psychometrics
  • Leadership
  • Humans
  • Hospitals
  • General & Internal Medicine
  • Delivery of Health Care
  • Cross-Sectional Studies
  • 4203 Health services and systems