title: The relationship between transformational leadership and social capital in hospitals--a survey of medical directors of all German hospitals.
abstract: BACKGROUND
  The German hospital market has been undergoing major changes in recent years. Success in this new market is determined by a multitude of factors. One is the quality of the social relationships between staff and the presence of shared values and rules. This factor can be considered an organization's "social capital."
  
  
  OBJECTIVE
  This study investigates the relationship between social capital and leadership style in German hospitals using a written survey of medical directors.
  
  
  METHODS
  In 2008, a cross-sectional representative study was conducted with 1224 medical directors from every hospital in Germany with at least 1 internal medicine unit and 1 surgery unit. Among the scales included in the standardized questionnaire were scales used to assess the medical directors' evaluation of social capital and transformational leadership in the hospital. We used a multiple linear regression model to examine the relationship between social capital and internal coordination. We controlled for hospital ownership, teaching status, and number of beds.
  
  
  METHODS
  In total, we received questionnaires from 551 medical directors, resulting in a response rate of 45.2%. The participating hospitals had an average of 345 beds. The sample included public (41.3%), not-for-profit (46.9%), and for-profit (11.7%) hospitals.
  
  
  RESULTS
  The data, which exclusively represent the perceptions of the medical directors, indicate a significant correlation between a transformational leadership style of the executive management and the social capital as perceived by medical directors. A transformational leadership style of the executive management accounted for 36% of variance of the perceived social capital.
  
  
  CONCLUSIONS
  The perceived social capital in German hospitals is closely related to the leadership style of the executive management. A transformational leadership style of the executive management appears to successfully strengthen the hospital's social capital.
authors.affiliation: Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Science and Faculty of Medicine, University of Cologne, Cologne, Germany. Antje.Hammer@uk-koeln.de
authors.forename: Antje
authors.initials: A
authors.lastname: Hammer
authors.forename: Oliver
authors.initials: O
authors.lastname: Ommen
authors.forename: Julia
authors.initials: J
authors.lastname: Röttger
authors.forename: Holger
authors.initials: H
authors.lastname: Pfaff
mesh_terms: D000288:Administrative Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D005858:Germany; D006280:Health Workforce / Q000191:economics / Q000458:organization & administration*; D016304:Hospitals, Private / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data*; D006788:Hospitals, Voluntary / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007857:Leadership; D012931:Social Environment; D011795:Surveys and Questionnaires