Servant-Leaders in the medical world


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by N. ten Hoven and M. Sivro
Workshop 4

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Servant-Leaders in the medical world

  1. 1. WORKSHOP IVSERVANT-LEADERSHIP IN THEMEDICAL WORLDMirna Sivro – Msc. in Business Administration (HRM)Nelleke ten Hove – Masterstudent Business Administration (HRM) (AlmostMsc ☺)
  2. 2. RESEARCH FOCUS VUmc introduced Servant-Leadership since 2000 Effects were never measured In 2009 dr. Inge Nuijten and dr. Dirk van Dierendonck introduced their multidimensional measure for Servant- Leadership VUmc was interested in the effects of Servant-Leadership within their organization
  3. 3. RESEARCH DILEMMA Literature ‘gap’: “Servant-Leadership is a leadership style that can bring back the trust, and among other things, increase follower well-being and performance” (Nuijten, 2009:9) To what extent does Servant-Leadership influence organizational and individual performance of the Vumc? (hard and soft performance indicators) Determination of potential “strategy gap”
  4. 4. RESEARCH QUESTIONS Mirna: What is the role of Servant-Leadership in creating and sustaining a High Performance Organization? (hard measure of performance) Nelleke: To what extent can a ‘strategy gap’ be identified between how on the one hand, management and, on the other hand, managements’ subordinates experience VUmc’s Servant-Leadership strategy, and is Servant-Leadership related to subordinates’ levels of organizational citizenship behaviour (ocb) via trust? (soft measure of performance)
  5. 5. RESEARCH CONCEPTS IServant-Leadership (SL): “A leadership style that is primarily focused on the growth and well-being of individuals. Furthermore, a Servant- Leader has moral character, the wisdom to foresee what is needed, the ability to meet the needs of people, and the courage to act on that” (Nuijten, 2009: 8)
  6. 6. RESEARCH CONCEPTS IServant-Leader characteristics (Nuijten, 2009): Serving: Leading: 1. Humility 1. Empowerment 2. Standing Back 2. Accountability 3. Forgiveness 3. Stewardship 4. Authenticity 4. Courage
  7. 7. RESEARCH CONCEPTS IIHigh Performance Organization (HPO) (hard measure): “An organization that achieves financial and non-financial results that are better than those of its peer group over a period of time of at least five to ten years” (De Waal, 2008: 2)
  8. 8. RESEARCH CONCEPTS IIHigh Performance Organization Factors:1. High Management Quality2. High Workforce Quality3. Long-Term Orientation4. Openness & Action Orientation5. Continuous Improvement & RenewalNote: these 5 factors contain 35 elements
  9. 9. RESEARCH CONCEPTS IIIOrganizational Citizenship Behaviour (OCB) (soft measure): “Such gestures as constructive statements about the department, expression of personal interest in the work of others, suggestions for improvement, training new people (…), care for organizational property, and punctuality and attendence well beyond standard or enforceable levels” (De Gilder et al., 2008) Behaviours that go beyond the “call of duty”
  10. 10. RESEARCH CONCEPTS IVTrust in Leader: The level of confidence that a subordinate has in the leaders’ competence and his or her willingness to act in a fair ethical and predictable manner (Nyhan & Marlowe, 1997)
  11. 11. RESEARCH CONCEPTS VStrategy Gap: “The gulf between strategies conceived by top management and awareness at lower levels” (Floyd & Wooldridge, 1992)
  12. 12. RESEARCH DESIGN + Figure 1: Integrated Research Design
  13. 13. SAMPLE COMPOSITION • 570 respondents contacted by letter • 100 departments in which 1 manager and 5 of its subordinates were represented • 89 usable respondents for the analysis • Responsrate of 15.6 % • Representative? – vraag Thijs
  14. 14. HPO RESULTS VUMC HPO results VUmc compared to the sector and Top 3 10 9 8 7 6 5 Cure and Care Sector 4 VUmc Score 3 Top 3 NL 2 1 0 Management Quality Openness and Action Long Term Continuous High Workforce Orientation Commitment Improvement and Quality Renewal Figure 2: HPO score Vumc compared to the sector and Top 3 performers
  15. 15. RESULTS I:SERVANT-LEADERSHIPAND HPO • Using the existing SL and HPO literature a theoretical comparison was made between the factors and elements of these concepts • In order to determine the (possible) influence of SL factors and elements on the HPO factors and elements a correlation analysis was done. • Correlation Analysis per function level
  16. 16. RESULTS I:CORRELATIONS HPO AND SL:Nursing and Other non leading personnel →Formal Leader (Administrative Manager) MQ SL-EMP SL-ACC SL-STEW SL-COUR SL-HUM SL-STBA SL-FOR SL-AUTHManagement Quality 1 Sig. (2-tailed) ,000** ,000** ,000** ,000** ,005** ,004** N 80 42Openness and Action Orientation ,000** ,003** ,000** ,017* ,000** ,010**Long Term Commitment ,001** ,010** ,000** ,002** ,003**Contineous Improvement ,007** ,001** ,000** ,026* ,005**Workforce Quality ,000** , ,000** ,000** ,000** ,013** Correlation is significant at the 0.05 level (2-tailed)** Correlation is significant at the 0.01 level (2-tailed)
  17. 17. RESULTS I:CORRELATIONS HPO AND SL:Nursing and Other non leading personnel →Informal/Direct Leader (e.g. Medical specialist) SL- SL- SL- SL- SL- MQ EMP ACC STEW COUR HUM SL-STBA SL-FOR SL-AUTH Management Quality 1 Sig. (2-tailed) ,036* N 80 42 Openness and Action Orientation ,014* Long Term Commitment ,008** ,043* Contineous Improvement Workforce Quality ,029* * Correlation is significant at the 0.05 level (2-tailed) ** Correlation is significant at the 0.01 level (2-tailed)
  18. 18. RESULTS I:CORRELATIONS HPO AND SL:Leading personnel → Informal/Direct Leader MQ SL-EMP SL-ACC SL-STEW SL-COUR SL-HUM SL-STBA SL-FOR SL-AUTHManagement Quality 1 Sig. (2-tailed) ,000** ,000** ,000** ,009** ,034* N 80 26Openness and Action Orientation ,000** ,014* ,000** ,000** ,002** ,009** ,027*Long Term Commitment ,000** ,002** ,000** ,034* ,030*Contineous Improvement ,009** ,004** ,018* ,014* ,003**Workforce Quality ,000** ,002** ,001*** Correlation is significant at the 0.05 level (2-tailed)** Correlation is significant at the 0.01 level (2-tailed)
  19. 19. RESULTS II:SL, TRUST AND OCB Figure 3: Mediation SL, Trust and OCB
  20. 20. RESULTS III:SL DIMENSIONSAND OCB Figure 4: SL dimensions in relation to OCB
  21. 21. RESULTS IV:STRATEGY GAPSignificant difference between Managers (formal leaders) and Subordinates(medical specialists and nurses)Significant difference between Nurses and Medical Specialists(informal leaders)Non-significant difference between Managers(formal) and Medical Specialists(informal managers) Managers MedicalStrategy Gap as indicator for areas Specialiststo improve with respect to Servant-LeadershipAre nurses “ready” for Servant-Leadership? Nurses
  22. 22. CONCLUSIONS I • Correlation results show that although there are many positive correlations between SL and HPO, there are also many differences between organizational levels and their function groups within the VUmc. This means that SL does not have the same infleunce on the HPO scores within the whole organization.
  23. 23. CONCLUSIONS IISpecific servant-leader behaviours are positively associated with trust inleader and ocb. Servant-leaders Forgiveness - Trust in Leader Servant-leaders Empowerment & Accountability – OCBServant-Leadership positively influences subordinates levels ocb, via trust inleader.
  24. 24. CONCLUSIONS III Inconsistencies exist between how servant-leadership is experienced on different organizational levels within the VUmc. However, the size of the gap is smaller than expected, it functions as an indicator for areas to improve with respect to servant-leadership.
  25. 25. IMPLICATIONS VUMC Bottom-up Approach Representatives for employees throughout organizational levels NursesEfforts to incorporate Medicalservant-leadership in the “heart Specialistsand mind” of every single VUmc employee. Managers
  26. 26. DISCUSSION POINTS • Could it be that servant-leadership is only successfull in a specific (serving) organizational context? • Or is there a need for servant-leadership in commercial organizational contexts and settings (retail, banking sector)? • Are all 21th century employees ready for servant- leadership?
  27. 27. THANK YOU FOR YOURATTENTION Are there any questions?