Assessing Leadership Behavior in Health Care: Introducing the Local Leadership Scale of the SCORE Survey

Area of Science:

• Healthcare Management
• Organizational Psychology
• Patient Safety

Background:

• Engaged leadership is crucial for healthcare excellence, yet brief, reliable measures of local leaders' feedback and coaching behaviors are lacking.
• Existing tools do not adequately capture actionable leadership behaviors essential for team performance and safety.

Purpose of the Study:

• Introduce and validate a five-item Local Leadership (LL) scale.
• Assess the LL scale's psychometric properties and benchmarking.
• Examine the association of local leadership with psychological safety and its prediction of restricted activities and absenteeism.

Main Methods:

• Cross-sectional study involving 23,853 questionnaires distributed across 31 Midwestern US hospitals.
• Utilized psychometric analyses (Cronbach's α, CFA, RMSEA, CFI, TLI) and correlational analyses.
• Assessed differences in LL scores based on healthcare worker roles, shifts, and work settings.

Main Results:

• The LL scale demonstrated strong psychometric properties (Cronbach's α = 0.94).
• LL scores varied significantly by role, shift, shift length, and specialty, with leaders rating leaders most favorably.
• Higher LL scores positively correlated with psychological safety, absenteeism, and restricted activities due to illness.

Conclusions:

• The Local Leadership (LL) scale is a psychometrically sound measure of leadership behaviors.
• LL scores provide valuable insights into variations across different healthcare settings and roles.
• The LL scale offers actionable data for leaders to enhance safety culture and team well-being.