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Leadership for Quality, Effectiveness and Health
Mid Sweden University, Faculty of Science, Technology and Media, Department of Engineering and Sustainable Development. (Kvalitetsteknik)ORCID iD: 0000-0002-7322-9346
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Leadership, quality, effectiveness and health are important factors in the achievement of organisational success. Three questions are addressed to study these elements:

1. How do leadership values relate to leadership behaviours, quality methodologies and health in organisations?

2. How do leadership behaviours relate to effectiveness and health in organisations?

3. How can leadership tools be designed and used to promote health in organisations?

The research is based on five studies from three research projects. This research is reported in five papers. Study I concerned eight organisations in the middle of Sweden; the focus was on leadership values and behaviours. Study II concerned three successful organisations that received the award, ‘Sweden’s number one workplace’. Focus in this study was mainly on leadership behaviours. Study III combined results from Studies I and II with a focus on successful leadership behaviours. Study IV concerned the eight organisations in Study I. A leadership tool in the form of a Plan-Do-Study-Act (PDSA) model was developed and evaluated. Study V was of two organisations in Sweden; the focus in that work was on the use of a leadership tool control chart designed to give managers statistically valid early warning signals about health in their organisations. Theory X and Y together with the three-dimensional leadership behaviour theory were used to assess leadership values and behaviours. The theory surrounding PDSA and control charts were used to develop leadership tools. The dimension of health is defined from a salutogenic humanistic perspective; which emphasizes individual well-being. The dimension of quality is defined as the ability to satisfy or exceed needs and expectations. Effectiveness is defined as the extent to which externally and internally defined objectives are fulfilled.

Both qualitative and quantitative research methods were used. Interviews, seminars with employees, collection of human resource and effectiveness figures, and questionnaires completed by managers and subordinates were used to collect data.

Managers with more Theory Y-oriented leadership values were rated by subordinates as high concerning quality methodologies and leadership behaviour dimensions. The subordinates of these managers tended to be healthier.

Two of the studies identified common groups of leadership behaviours in effective and healthy organisations: strategy and vision, communication and information, authority and responsibility, learning culture, worker conversations, plainness and simplicity, humanity and trust, walking around and reflective personal leadership.

These leadership behaviours fit into a leadership profile where all three of the dimensions of structure, relation and change are present. Of the three, the relation dimension is strongest and concluded to be a universal dimension.

The developed PDSA model seems to be a leadership tool that influences both leadership values and behaviour, particularly in the area of relation-oriented leadership behaviours. An early warning system built on CUSUM- and Shewhartcharts concerning the health indicators of self-assessed general health and new sickcases per employee was also found to be a powerful and usable leadership tool.

For future research, the explorative research findings can be quantitatively tested using representative and preferably cross-national data, with a longitudinal design.

Abstract [sv]

Ledarskap, kvalitet, effektivitet och hälsa är viktiga faktorer för en organisations framgång. Tre forskningsfrågor är ställda:

1. Hur relaterar ledarskapsvärderingar till ledarskapsbeteenden, arbetssätt för kvalitet samt hälsa i organisationer?

2. Hur relaterar ledarskapsbeteenden till effektivitet och hälsa i organisationer?

3. Hur kan hälsofrämjande ledarskapsverktyg utformas och användas i organisationer?

Forskningen är baserad på fem studier med empirisk bas i tre forskningsprojekt. Resultaten är avrapporterade i fem artiklar. Studie I inkluderar åtta organisationer i mellansverige; fokus är på värderingar och beteenden inom ledarskapet. Studie II inkluderar tre framgångsrika organisationer som har erhållit utmärkelsen “Sveriges bästa arbetsplats” och fokus är framförallt på ledarskapsbeteenden. Studie III är en kombination av resultat från Studie I och II och fokuserar på framgångsrikt ledarskap. Studie IV inkluderar organisationerna från Studie I, och ett ledarskapsverktyg i form av en PDSA modell är utvecklad och utvärderad. Studie V inkluderar två organisationer och fokuserar på ledarskapsverktyget styrdiagram med målet att ge chefer statistiskt säkerställda tidiga varningar rörande medarbetarnas hälsa. Teori X och Y är, tillsammans med den tredimensionella ledarskapsbeteendeteorin, teoribas för analys av värderingar och beteenden inom ledarskapet. Teorier rörande PDSA och styrdiagram är använda för att utveckla ledarskapsverktyg. Hälsa är definierad med ett salutogent humanistiskt perspektiv som betonar det individuella välbefinnandet.

Kvalitet som en produkts förmåga att tillfredsställa eller helst överträffa kundernas behov och förväntningar. Effektivitet som både intern och extern måluppfyllelse. Både kvalitativa och kvantitativa forskningsmetoder är använda i studierna. Intervjuer, gruppseminarier med medarbetare, insamling av personaladministrativa data och effektivitetsindikatorer samt frågeformulär till chefer och medarbetare är använda som datainsamlingsverktyg.

Chefer med mer Teori Y-orienterade värderingar bedöms av medarbetare ha höga värden rörande arbetssätt för kvalitet, ledarskapsbeteenden samt tendenser till bättre hälsa bland medarbetarna.

Gemensamma grupper av ledarskapsbeteenden från två studier hos framgångsrika organisationer är identifierade; Den strategiska och visionära ledarskapsrollen, Kommunikation och information, Ansvar och befogenheter, Lärande kultur, Medarbetardiskussioner, Enkelhet, Humanitet och förtroende, Vara synlig i organisationen och Personligt reflektivt ledarskap. Dessa beteenden motsvarar en ledarskapsprofil inkluderande de tre dimensionerna struktur, relation och förändring. Tydligast i resultaten är relationsdimensionen och slutsatsen är att den är universell.

Den utvecklade PDSA modellen verkar vara ett tillämpbart ledarskapsverktyg som influerar både ledarskapsvärderingar och ledarskapsbeteenden, framförallt ökad relationsorientering. Ett tidigt varningssystem innehållande hälsoindikatorerna självskattat allmänt hälsotillstånd och nya sjukfall per anställd med styrdiagrammen CUSUM och Shewhart är ett kraftfullt och användbart ledarskapsverktyg.

I fortsatt forskning kan de explorativa resultaten testas kvantitativt med representativa, helst internationella, data utifrån en longitudinell design.

Place, publisher, year, edition, pages
Östersund: Mittuniversitetet , 2010. , p. 179
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 79
Keywords [en]
Leadership, Values, Behaviours, Tools, Quality, Effectiveness, Health, Ledarskap, Värderingar, Beteenden, Verktyg, Kvalitet, Effektivitet, Hälsa
Keywords [sv]
Kvalitetsteknik
National Category
Production Engineering, Human Work Science and Ergonomics Other Mechanical Engineering
Identifiers
URN: urn:nbn:se:miun:diva-11218ISBN: 978-91-86073-65-7 (print)OAI: oai:DiVA.org:miun-11218DiVA, id: diva2:291475
Public defence
2010-02-26, F234, Campus Östersund, Östersund, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2010-02-02 Created: 2010-02-01 Last updated: 2018-11-27Bibliographically approved
List of papers
1. Leadership, quality and health: using McGregor's X and Y theory for analyzing values in relation to methodologies and outcomes
Open this publication in new window or tab >>Leadership, quality and health: using McGregor's X and Y theory for analyzing values in relation to methodologies and outcomes
2007 (English)In: Total Quality Management and Business Excellence, ISSN 1478-3363, E-ISSN 1478-3371, Vol. 18, no 9-10, p. 1147-1168Article in journal (Refereed) Published
Abstract [en]

Sweden has experienced an increase in sickness absenteeism, stress related health problems and a deterioration of psychosocial working conditions. Several researchers have emphasized that leadership with a focus on developing human resource practices is a necessary component of a high organizational performance. The purpose of this article is to explore whether there are patterns in leadership values and methodologies associated with subordinates´ views of leadership, health outcomes and quality aspects. Four public and four private organizations in northern Sweden were studied. McGregor´s X and Y hypotheses, plus three other hypotheses, were used as a base for the analyses. Data was gathered through in-depth interviews with the leaders, questionnaires (completed by leaders and co-workers), and assessment of selected human resource accounting data (sickness absenteeism). The leader views were mirrored with the co-worker views through a comparison of qualitative and quantitative results in a stepwise analysis process. The study´s main findings were that leaders with more X hypotheses get lower results concerning employee judged leadership and quality aspects and, to some extent, lower results concerning health outcomes. The explanatory analyses concerning leadership and health are complex with many influencing factors.

Keywords
Leadership, Leadership Values, Methodologies, Quality Improvement, Quality Development, Customer Satisfaction, Health, Working Environment, Quality Technology and Management, TQM, Quality control, Kvalitetsteknik, Kvalitet
National Category
Other Mechanical Engineering
Identifiers
urn:nbn:se:miun:diva-4016 (URN)10.1080/14783360701596290 (DOI)000252250300014 ()2-s2.0-38749111450 (Scopus ID)4497 (Local ID)4497 (Archive number)4497 (OAI)
Available from: 2008-12-09 Created: 2008-12-09 Last updated: 2018-11-27Bibliographically approved
2. Leadership and organizational behaviour: Similarities between three award-winning organizations
Open this publication in new window or tab >>Leadership and organizational behaviour: Similarities between three award-winning organizations
2009 (English)In: International Journal of Management Practice, ISSN 1477-9064, E-ISSN 1741-8143, Vol. 3, no 4, p. 327-345Article in journal (Refereed) Published
Abstract [en]

Purpose

The purpose of this paper is to examine if healthy and successful organizations are working accordingly to Quality Management. The purpose is also to describe how the organizations are working.

 

Methodology/Approach

Three Swedish organizations that have shown excellence in leadership, internal partnership, working environment and profitability have been examined, to find out what methodologies they have been used for their success. To find out if the healthy and successful organizations are working accordingly to Quality Management, Deming’s 14 point list have been used as analysing tool.

 

Findings

Indentified methodologies used by the healthy and successful organisations are described.  Viewed through our analysis, a relationship between the three examined healthy and successful organizations and Quality Management is indicated.

 

Practical implications

Working with the methodologies described in the paper, the three organizations have improved co-worker health. Other organizations could probably adopt the identified and described methodologies to improve the health of their co-workers and effectiveness in the organization.

 

Originality/value

Concerning the performance evaluation and the continuous improvement component in Quality Management, substantial contributions could be made to the health area by applying the tools that the quality area have used for such a long time to improve the quality outcomes.

Quality and health aspects have common success factors, and a focus on high quality could be seen as positive for health outcomes.

 

Keywords
Quality Management, health, leadership, methodologies, performance, effectiveness, Quality Technology and Management, TQM, Quality control, leadership; successful organisations; quality management; organisational effectiveness; organisational behaviour; workplace health promotion; management practice; work environment; hospitals; manufacturing; Sweden; corporate strategy; corporate vision; communication strategies; learning culture; worker conversations; management by walking around; customer satisfaction; leadership chain modelling; Best Workplace in Sweden award, Kvalitetsteknik, Kvalitet
National Category
Other Mechanical Engineering
Identifiers
urn:nbn:se:miun:diva-6166 (URN)10.1504/IJMP.2009.026960 (DOI)2-s2.0-68049130008 (Scopus ID)4500 (Local ID)4500 (Archive number)4500 (OAI)
Available from: 2008-12-07 Created: 2008-12-07 Last updated: 2018-11-27Bibliographically approved
3. Leadership behaviour in successful organisations: Universal or situation-dependent?: Universal or situational-dependent?
Open this publication in new window or tab >>Leadership behaviour in successful organisations: Universal or situation-dependent?: Universal or situational-dependent?
2010 (English)In: Total quality management and business excellence (Online), ISSN 1478-3363, E-ISSN 1478-3371, Vol. 21, no 3, p. 317-334Article in journal (Refereed) Published
Abstract [en]

Leadership behaviour has a critical role in the creation of successful organisations. This article reviews dimensions of leadership behaviour theory and their relationship to effectiveness, productivity, quality, health and job satisfaction in organisations. The article has two purposes: (1) to identify and summarise leadership behaviours common among successful organisations; and (2) to use these common elements to discuss those theoretical implications which concern situational aspects of successful leadership behaviour. The successful organisations studied for this work were two manufacturing companies, one hospital and one retail operation. The case studies were performed in connection with two leadership research projects. They focused on quality work, effectiveness, working environment, subordinate health and perceptions of the leadership. The common leadership behaviours were explored using a comparative qualitative method. The identified common leadership behaviours were then analysed in relation to the three-dimensional leadership behaviour theory (change-, structure- and relation-orientation) to explore distributions between dimensions. Nine common groups of behaviours were identified and described. The qualitative analyses showed that the identified behaviours were in all three behaviour dimensions. Also evident was that relation-oriented leadership behaviour was by far the strongest of the three. The conclusion is that a successful leader uses high relation-orientation as a base. At the same time, this successful leader uses all three behaviour dimensions. The two additional dimensions of structure- and change-orientation can be altered by leaders according to situational factors. This conclusion implies that successful leadership behaviour includes both universal and contingency elements.

Place, publisher, year, edition, pages
London: Taylor & Francis, 2010
Keywords
Leadership, Effectiviness, Productivity, Job satisfaction, Health, Situation
National Category
Other Mechanical Engineering
Identifiers
urn:nbn:se:miun:diva-6469 (URN)10.1080/14783360903561779 (DOI)000277751000006 ()2-s2.0-77951240111 (Scopus ID)5129 (Local ID)5129 (Archive number)5129 (OAI)
Available from: 2009-02-18 Created: 2009-02-18 Last updated: 2018-11-27Bibliographically approved
4. To Control with Health - From Statistics to Strategy
Open this publication in new window or tab >>To Control with Health - From Statistics to Strategy
2009 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 32, no 1, p. 49-57Article in journal (Refereed) Published
Abstract [en]

The main purpose of this study is to develop and test a generic model for workplace health management in organizations. Four private and four public organizations in northern Sweden were selected for the study. A model for health control was developed on the basis of a literature review and dialogues with the stakeholders in the workplaces. The model was then implemented at the workplaces during a two-year period. Interviews with leaders and sub-leaders were conducted on two occasions and were analyzed using content analysis and the constant comparison method. By using a grounded theory approach, three main categories were found: health closure and other health and working environment indicators, monetary accounting of health related indicators and changes in leadership behaviour and organizational practices. An important result was that the model influenced leadership values more than leadership and organizational methodologies. From the results a model for workplace health management is proposed, incorporating the planning, control, and improvement structures. The purpose of the model is to take health aspects into consideration when deciding organizational structure (work demands, control and social support). The model controls health by using health-related indicators with high frequency measuring whereas workplace health promotion is done in a structured way with a reflective model.

Keywords
Health, health closures, workplace health management, workplace health promotion, sickness absence, human resource accounting, quality control, organizational change, learning organization
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-6440 (URN)10.3233/WOR-2009-0815 (DOI)000264554800007 ()19276525 (PubMedID)2-s2.0-62149124395 (Scopus ID)4885 (Local ID)4885 (Archive number)4885 (OAI)
Available from: 2009-02-18 Created: 2009-02-18 Last updated: 2018-11-27Bibliographically approved
5. Control charts as an early warning system for workplace health outcomes
Open this publication in new window or tab >>Control charts as an early warning system for workplace health outcomes
2011 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 39, no 4, p. 409-425Article in journal (Refereed) Published
Abstract [en]

 Introduction: Statistical Process Control (SPC) charts have not been widely used to monitor workplace health and work environments. This research and effort to develop a more accurate and easy to use management control system for employee health is important from a humanistic, societal and economic standpoint, as well as complying with laws that regulate work environments. Objective: The purpose of the study is to design and discuss control charts as an early warning system for workplace health outcomes to promote workplace health management. Another purpose is to discuss relevant factors in the concept of the Out-of-Control Action Plan (OCAP) as a response when a chart warns that the workplace process may be malfunctioning. Participants: Two Swedish organizations were selected as case study organizations: a department at a university and an elderly care operation in a municipality. Methods: This study was explorative and should be seen as a starting point in learning how to use control charts for workplace health management. Self-assessed general health and new sick-cases per employee were selected as indicators for the control charts. Results: An integrated early warning system with Cumulative Sums-and Shewhart-charts are presented to show a possible method as to how an early warning system can be structured through the use of statistical control charts. Conclusions: The conclusion of this study is that control charts, along with well-designed implementation, make up a powerful and useable managerial early-warning system which promotes workplace health and helps to prevent sickness absence.

Keywords
Control charts, health, sickness, sickness absence, early warning system, leadership
National Category
Production Engineering, Human Work Science and Ergonomics
Identifiers
urn:nbn:se:miun:diva-10409 (URN)10.3233/WOR-2011-1191 (DOI)000293836000008 ()21811031 (PubMedID)2-s2.0-80051518343 (Scopus ID)
Available from: 2009-11-26 Created: 2009-11-26 Last updated: 2018-11-27Bibliographically approved

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Larsson, Johan

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