Date

12-4-2025

Department

Graduate School of Business

Degree

Doctor of Philosophy in Organization and Management (PhD)

Chair

C Brandt Smith

Keywords

healthcare leadership, employee engagement, quality outcomes, employee turnover, organizational management

Disciplines

Human Resources Management | Leadership Studies

Abstract

This quantitative, causal-comparative study examined the relationship between leadership effectiveness, employee engagement, quality outcomes, and turnover in non-profit acute care hospitals in Texas. Guided by a pragmatic paradigm, the research utilized archived data to analyze correlations among leader effectiveness scores, employee engagement levels, patient quality metrics, and employee turnover rates. Grounded in Maslow’s Hierarchy of Needs, the Motivation-Hygiene Theory, Job Demands-Resources Theory, Path-Goal Theory, and Relational Leadership Theory, the study explored how leadership behaviors and engagement strategies influence organizational outcomes. Results revealed a strong positive correlation between effective leadership and employee engagement, indicating that leaders who provide support, recognition, and clear direction foster higher engagement levels among frontline staff. Although engagement did not directly predict quality outcomes, leadership served as a mediating factor linking engagement to performance. Additionally, a negative correlation was identified between engagement and turnover, suggesting that improving leadership development and engagement strategies can significantly reduce costly attrition. The findings contribute to organizational management and healthcare leadership literature by emphasizing leadership’s pivotal role in cultivating engagement and sustaining workforce stability. By developing effective, relationally focused leaders, healthcare organizations can enhance employee well-being, improve care quality, and promote long-term operational success.

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