Abstract
The purpose of this study is to understand the relationship between roles of transformational and transactional leadership behaviors, types of a current organizational culture, and attributes of the learning organization in both private and public certified and accredited hospitals. The study has the following four objectives: 1) to test the relationship between leadership behaviors as perceived by administrators and the learning organization and each of its attributes, 2) to determine how much variation and what direct effect leadership behaviors have on learning organizations as perceived by subordinates, 3) to determine how much variation types of current organizational culture (achievement, support, role, and power–oriented culture) have on learning organizations, including both private and public hospitals, 4) to compare variations in indirect effects of leadership behaviors on learning organizations with regard to types of current organizational culture as perceived by subordinates, and 5) to confirm and compare the path analysis of a theoretical model showing subordinates perceived causality between eight roles of leadership behavior, four roles of a current organizational culture, and the development of a learning organization. The quantitative study utilized information from eight hundred healthcare professions systematically selected from nine hospitals in both sectors having been certified and accredited with HA since 1995. Five hundred and fifty respondents from different levels and jobs involved with quality improvement programs completed the questionnaire that was sent to them. Multiple regression using a stepwise technique was utilized for analyzing hospital’s chief executive perception of the eight roles of transformational and transactional leadership behaviors and to determine variance in the development of a learning organization. The results indicated that chief executives in both private and public hospitals viewed themselves as leaders performing transactional leadership behavior, with the producer role explaining 20% of the variance in the development of a learning organization. Regarding the significant relationship of each attribute of a learning organization, transactional leadership role of producer was a significant predictor of knowledge system and explained 29% of the variation. Chief executives with producer role, thus emphasized the knowledge system, that is, the development of new knowledge and insights that have the potential to influence behavior. The study also conducted semi-structured interviews with the chief executives of the hospitals to obtain their perception on the current organizational culture to gain insight about how the organizational culture has changed over time since they have participated in HA.For the subordinate’s perception of both two sectors, this study used quantitative techniques through a questionnaire survey. Descriptive statistics and structural equation modeling (SEM) based on LISREL methodology were applied to analyze the results. Direct and indirect effects were examined. The private hospitals’ learning organization model indicates that the development of a learning organization was directly influenced by transactional leadership (the director role) and transformational leadership (the broker role), regardless of the nature of organizational culture. For the public hospitals’ learning organization model, it indicates learning organization was directly influenced by transactional leadership (the producer and director role), regardless of organizational culture. Furthermore, the private hospitals’ learning organizational model illustrates that the development of a learning organization from learning the process of how to initiate and implement hospital accreditation successfully is indirectly affected by leaders using the coordinator role through the achievement culture and the supportive culture respectively. The public hospitals’ learning organization model indicates that the development a learning organization is indirectly influenced by transformational leadership (the mentor role) and transactional leadership (the director, coordinator, and monitor role) via achievement–oriented culture and supportive culture or via achievement–oriented culture and role-oriented culture respectively. Consequently, 42% of the variation in private hospitals’ learning organization model and 49% of the variation in public hospitals’ learning organization model were explained. Finally, the learning organization model in both private and public hospitals was found to adequately fit the hypothesized structural model with the satisfactory goodness-of-fit level. In addition, the results indicate the learning organization would not exist without the two supporting foundations of appropriate leadership behavior and organizational culture. Thus, the findings suggest that leadership behavior influences the organizational culture and is deemed an appropriate starting point in the casual relationship model. It confirms a theoretical model claiming that subordinates of both sectors see causality between leadership behaviors, a current organizational culture, and a learning organization. For future research, it is recommended to replicate the study but also include the measurement of a current organizational culture as perceived by the leaders. Thus, the replicated study will be able to compare and confirm two causal models of the development of a learning organization between leader’s perception and subordinate’s perception. With in this regard, the results of the future study will show whether or not a discrepancy exists between them. Moreover, replication of this study in other organizations such as educational institute would be useful. A follow-up study after several years of HA would indicate whether or not the attributes of a learning organization have been sustained in these hospitals. The results of the study also point to two important practical implications for organizational policy and human resource management. First, the training program for leaders is in organizational culture management because the development of a learning organization gained from learning how to implement quality improvement will be not sustained, unless culture of hospital change. The culture change process is recommended. The second implication on this study includes a leadership training and development program for chief executives of both private and public hospital.
