title: Manager traits and quality-of-care performance in hospitals.
abstract: OBJECTIVE
  This paper aims to assess the impact of the leadership traits of chief executive officers (CEOs) on hospital performance in the USA. The effectiveness and efficiency of the CEO is of critical importance to the performance of any organization, including hospitals. Management systems and manager behaviours (traits) are of crucial importance to any organization because of their connection with organizational performance. To identify key factors associated with the quality of care delivered by hospitals, the authors gathered perceptions of manager traits from chief executive officers (CEOs) and followers in three groups of US hospitals delivering different levels of quality of care performance.
  
  
  METHODS
  Three high- and three low-performing hospitals were selected from the top and bottom 20th percentiles, respectively, using a national hospital ranking system based on standard quality of care performance measures. Three lean hospitals delivering intermediate performance were also selected. A survey was used to gather perceptions of manager traits (providing a modern or lean management system inclination) from CEOs and their followers in the three groups, which were compared.
  
  
  RESULTS
  Four traits were found to be significantly different (alpha < 0.05) between lean (intermediate-) and low-performing hospitals. The different perceptions between these two hospital groups were all held by followers in the low-performing hospitals and not the CEOs, and all had a modern management inclination. No differences were found between lean (intermediate-) and high-performing hospitals, or between high- and low-performing hospitals.
  
  
  CONCLUSIONS
  These findings support a need for hospital managers to acquire appropriate traits to achieve lean transformation, support a benefit of measuring manager traits to assess progress towards lean transformation and lend weight to improved quality of care that can be delivered by hospitals adopting a lean system of management.
authors.affiliation: Department of Anaesthesiology & Operative Care, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Kjeld Harald
authors.initials: KH
authors.lastname: Aij
authors.forename: René L M C
authors.initials: RL
authors.lastname: Aernoudts
authors.forename: Gepke
authors.initials: G
authors.lastname: Joosten
mesh_terms: D016542:Chief Executive Officers, Hospital; D006761:Hospitals; D006801:Humans; D007857:Leadership; D011787:Quality of Health Care
keywords: Health leadership competencies; Hospitals; Management effectiveness; Measurement; Performance; Process management