Campus Location

Dallas Campus (Online)

Date of Award

2-2021

Department

Educational Leadership

Degree Name

Doctor of Education

Committee Chair or Primary Advisor

Cecilia Hegamin-Younger

Second Committee Member or Secondary Advisor

Jenifer Williams

Third Committee Member or Committee Reader

Joe Cardot III

Abstract

The logics of medical professionalism and managerialism often result in differences in perspectives and conflicting prioritization of healthcare delivery, resulting in interprofessional conflict that stymies healthcare reform initiatives. In the context of dialysis joint ventures in the chronic healthcare setting, interprofessional conflict threatens the collaborative processes needed to deliver the desired clinical and financial performance outcomes. This study sought to explore the influence of leadership behaviors on the manifestation of collaboration and conflict in dialysis joint ventures to provide leaders with recommendations on how to modify behaviors to achieve desired outcomes. Six dyads of physicians and managers, three dyads from high- and three from low-performing joint ventures, participated in semistructured interviews. The purposeful selection of high- and low-performing ventures facilitated a differentiation in experiences and perspectives. Analysis of participant data relied upon the interpretative phenomenological analysis methodology, moving beyond descriptive phenomenology to explore how the participants made sense of their experiences. The data analysis revealed four superordinate themes that suggest leadership and communication behaviors that support inclusion, open-mindedness, and concern for the patient lessen professional identity salience and create the space to enjoy a team identity founded in trust and the desire for collaboration and compromise. Conversely, information withholding, controlling behaviors, and an overemphasis on financials created barriers to success by overemphasizing individual identity salience. These leadership differences differentiated high- versus low-performing ventures. The results of this study support prior literature in the acute setting suggesting the importance of leader attentiveness to team building through the creation of shared norms, common values and a team identity that values inclusion, debate, and compromise. Similarly, effective leaders engage frequently with transparent communication, fostering trusting relationships that allow the emergence of collaborative relationships. As a word of caution, overemphasizing financial performance and engaging in efforts to create alignment to organizational goals stimulated average or subaverage performance of the ventures.

Keywords: alignment, collaboration, communication, engagement, healthcare reform, inclusion, inclusive leadership, interprofessional conflict, joint venture, leadership, medical professionalism, managerialism, open-mindedness, and social identity theory

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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