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The impact of middle manager affective commitment on perceived improvement program implementation success.

Ashley-Kay Fryer¹, Anita L Tucker, Sara J Singer

¹Ashley-Kay Fryer, PhD, is Director of Strategy, Optum Analytics, Boston, Massachusetts. E-mail: afryer@post.harvard.edu. Anita L. Tucker, DBA, is Associate Professor, Questrom School of Management, Boston University, Boston, Massachusetts. Sara J. Singer, PhD, MBA, is Professor of Health Care Management and Policy, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

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|July 6, 2017

Summary

Middle manager commitment to improvement programs boosts success by enhancing frontline worker support. Organizational support also strengthens manager commitment, leading to better implementation outcomes.

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Area of Science:

Healthcare Management
Organizational Behavior
Implementation Science

Background:

Middle manager affective commitment (emotional attachment, identification, involvement) is linked to improvement program success.
The interplay between middle manager and frontline worker commitment in program implementation requires further investigation.

Purpose of the Study:

To assess the relationship between middle manager affective commitment and perceived implementation success.
To determine if frontline worker support mediates this relationship.
To examine the role of organizational support factors in fostering middle manager affective commitment.

Main Methods:

Surveyed 67 nurse managers across 19 U.S. hospitals regarding their falls reduction program.
Utilized hierarchical linear regression to analyze relationships between manager commitment, frontline worker support, organizational support, and implementation success.

Main Results:

Middle manager affective commitment positively correlates with perceived implementation success.
Frontline worker support mediates the relationship between manager commitment and implementation success.
Manager commitment mediates the link between organizational support and implementation success.

Conclusions:

Middle manager affective commitment, frontline worker support, and organizational support are key empirical factors for successful improvement program implementation.
Enhancing middle manager commitment can improve program success by fostering frontline worker support.
Organizational support is crucial for bolstering middle manager affective commitment.