servant-leaders in the medical world

WORKSHOP IVWORKSHOP IV

SERVANT-LEADERSHIP IN THE

MEDICAL WORLDMirna Sivro – Msc. in Business Administration (HRM)Nelleke ten Hove – Masterstudent Business Administration (HRM) (Almost Msc ☺)

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

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)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”

RESEARCH QUESTIONS

� Mirna:What is the role of Servant-Leadership in creating and sustaining a High Performance Organization? (hard measure of performance)

� Nelleke:� 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)

RESEARCH CONCEPTS I

Servant-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 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)

RESEARCH CONCEPTS I

Servant-Leader characteristics (Nuijten, 2009):

Serving: Leading:1. Humility 1. Empowerment2. Standing Back 2. Accountability2. Standing Back 2. Accountability3. Forgiveness 3. Stewardship4. Authenticity 4. Courage

RESEARCH CONCEPTS II

High 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 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)

RESEARCH CONCEPTS II

High Performance Organization Factors:

1. High Management Quality

2. High Workforce Quality

3. Long-Term OrientationLong-Term Orientation

4. Openness & Action Orientation

5. Continuous Improvement &

Renewal

Note: these 5 factors contain 35 elements

RESEARCH CONCEPTS III

Organizational 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 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”

RESEARCH CONCEPTS IV

Trust 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 competence and his or her willingness to act in a fair ethical

and predictable manner (Nyhan & Marlowe, 1997)

RESEARCH CONCEPTS V

Strategy Gap:

“The gulf between strategies conceived by top management and “The gulf between strategies conceived by top management and

awareness at lower levels” (Floyd & Wooldridge, 1992)

RESEARCH DESIGN

+

Figure 1: Integrated Research Design

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• 89 usable respondents for the analysis

• Responsrate of 15.6 %

• Representative? – vraag Thijs

HPO RESULTS VUMC

5

6

7

8

9

10

HPO results VUmc compared to the sector and Top 3

Cure and Care Sector

0

1

2

3

4

Management Quality Openness and Action

Orientation

Long Term

Commitment

Continuous

Improvement and

Renewal

High Workforce

Quality

Cure and Care Sector

VUmc Score

Top 3 NL

Figure 2: HPO score Vumc compared to the sector and Top 3 performers

RESULTS I:

SERVANT-LEADERSHIP

AND 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

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-AUTH

Management Quality 1

Sig. (2-tailed)

,000** ,000** ,000** ,000** ,005** ,004**

N 80 42

Openness 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)

RESULTS I:

CORRELATIONS HPO AND SL:

Nursing and Other non leading personnel →

Informal/Direct Leader (e.g. Medical specialist)

MQ

SL-

EMP

SL-

ACC

SL-

STEW

SL-

COUR

SL-

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)

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-AUTH

Management Quality 1

Sig. (2-tailed)

,000** ,000** ,000** ,009** ,034*

N 80 26

Openness and Action Orientation

,000** ,014* ,000** ,000** ,002** ,009** ,027*

Long Term Commitment 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)

RESULTS II:

SL, TRUST AND OCB

Figure 3: Mediation SL, Trust and OCB

RESULTS III:

SL DIMENSIONS

AND OCB

Figure 4: SL dimensions in relation to OCB

RESULTS IV:

STRATEGY GAP

� Significant 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(informal managers)

� Strategy Gap as indicator for areas

to improve with respect to Servant-Leadership

� Are nurses “ready” for Servant-Leadership?

Managers

Medical

Specialists

Nurses

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 thegroups within the VUmc. This means that SL does not have the

same infleunce on the HPO scores within the whole organization.

Specific servant-leader behaviours are positively associated with trust in

leader and ocb.

� Servant-leaders Forgiveness - Trust in Leader

� Servant-leaders Empowerment & Accountability – OCB

Servant-Leadership positively influences subordinates levels ocb, via trust in

CONCLUSIONS II

Servant-Leadership positively influences subordinates levels ocb, via trust in

leader.

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.

CONCLUSIONS III

improve with respect to servant-leadership.

IMPLICATIONS VUMC� Bottom-up Approach

� Representatives for employees

throughout organizational levels

Efforts to incorporate

Nurses

Efforts to incorporate

servant-leadership in the “heart

and mind” of every single VUmc employee.

MedicalSpecialists

Managers

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)? sector)?

• Are all 21th century employees ready for servant-

leadership?

THANK YOU FOR YOUR

ATTENTION

Are there any questions?