THOSE WITH THE MOST FIND IT HARDEST TO SHARE: EXPLORING LEADER RESISTANCE TO THE IMPLEMENTATION OF TEAM-BASED EMPOWERMENT

摘要

We use a convergent parallel mixed methods approach to explore barriers to the successful implementation of a team-based empowerment initiative within the Veterans Health Administration. Although previous research has suggested that leaders often actively obstruct empowerment initiatives, little is known about the reasons behind and effects of such hindering. Using a longitudinal quasi-experimental design, we support a hypothesis that higher-status physician leaders are less successful than lower-status nonphysician leaders in implementing team-based empowerment. In parallel, we analyze qualitative data obtained through interviews conducted during early months of the teambased empowerment initiative to identify common themes for why and how leaders facilitated or obstructed implementation. Leader identity work and leader delegation were identified as themes explaining (1) why higher-status leaders struggled with the new empowering role and (2) how specific leader actions either facilitated or inhibited sharing of tasks and leadership. Results suggest that team-based empowerment creates a status threat for high-status leaders who then struggle to protect their old identity as someone with distinct professional capabilities, which in turn leads to improper delegation behavior. Therefore, in order for team-based empowerment to succeed, leaders may need to change their perceptions of who they are before they will change what they do.