Doctoral Dissertations

Date of Award

5-1996

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Human Ecology

Major Professor

Gregory C. Petty

Committee Members

Wallace, Clifton P. Campbell, David Craig

Abstract

The primary problem investigated in this study is the need for improving the performance and effectiveness of leadership in public health. The frequency of workplace practices which public health directors initiate for developing high performance in their agencies was measured with a survey instrument developed for this purpose.

The entire population of health directors in North Carolina was assessed for this study and 76 directors responded giving a response rate of 88.4%. The study was conducted in November, 1995. Items for the survey instrument were drawn from a literature review of leadership in high performance workplaces, incorporating practices from business, industry, and government.

The first research question posed in this study was: What are the high performance workplace practices initiated by leaders that are most often used in North Carolina health agencies? The study found that the health directors often employed high involvement practices, frequently giving staff information about the goals and purposes of agency undertaking and assigning staff to planning groups. Skill training in technical areas and in computer use was rated highly as a training activity. Directing staff toward group achievement and applying new job skills toward service quality improvement was also frequently initiated.

Less frequent practices included training staff in continuous improvement skills of benchmarking, decision-making, statistical measures of quality, and analyzing work flows or work processes. Decentralized quality control, self-directed teams, reduced management layers, and financial rewards for performance were also not often employed.

The second research question asked: How are the frequency and type of high performance workplace practices initiated by leaders related to agency demographics? The study found that the experience of the director had little relationship to the workplace practices that were initiated. However, the size of the agency, measured by number of employees or population served, was correlated to the frequency of specific training and performance assessment-feedback practices.

The third research question asked: What are the barriers and resources for initiating high performance workplace practices and how do these factors relate to demographic factors and to the workplace practices leaders initiate? The study found that lack of funds to reward good employees and inflexible personnel systems were the greatest barriers to improving agency performance. Support from the local board of health and staff loyalty were the greatest resources. Levels of barriers and resources were not shown to be related to agency demographics, but levels of barriers were often related to lower frequencies of high performance workplace practices.

The study concluded that the local health directors initiated a number of high performance workplace practices but that leadership for performance improvement was diminished by barriers of funding, inflexible personnel systems, and the lack of community/ political support. The study recommends increased research in public health leadership, focusing on how it influences quality, production and agency performance.

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