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ROTC Verse Career Expectations in Leadership Skills: A Content Analysis
No full textThis is a video to accompany a SOARS poster presented in 2023
Presenteeism in the Workplace: An Exploration of Supervisors' Perspective and Employee Outcomes
No full textPresenteeism or sickness presenteeism was defined by Johns (2010) as “attending work while ill,” and other authors have posited that “sickness presenteeism” refers to a continued presence at work despite a health condition. This dissertation examined best practices for supervising employees with health conditions and presenteeism. Presenteeism increases costs for employers through decreased productivity, high turnover rates, and increased healthcare expenses. Because presenteeism is a global phenomenon, there is a need to explore the best method supervisors can use to manage employees with health conditions and presenteeism. This systematic review of 45 quality-appraised articles via the Mixed Methods Appraisal Tool explored factors that affected individual health and its impact on the job. Managerial work-related factors, roles, communication, and the work environment impact the employee’s health and presenteeism. This dissertation also explored ways to manage employees effectively and efficiently with health conditions and presenteeism; it focused on the supervisor-employee relationship and the supervisor’s role in the process. This qualitative study showed that employees with health conditions and presenteeism did impact the workplace and that managerial factors, including leadership style, relationships, job role, and demographics, affected employees with health conditions and presenteeism. Organizational rules and regulations that managers or supervisors apply also affected employees’ presenteeism. Costs due to work-related problems and rewards played a role in presenteeism. Communications from supervisors and coworkers and disclosure of one’s disability or illness helped supervisors better ascertain avenues for employee accommodations. Building relationships with coworkers, colleagues, supervisor(s), and family assured social support for the worker. The effect of employee health conditions and presenteeism calls for additional research in aligning strategies that can be applied within different organizations and industries. It also calls for exploring if/how knowledge of a presenteeism culture brings awareness and training to leadership, management, staff, supervisors, colleagues, and coworkers on the impacts of employee presenteeism.PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF i
Title of Dissertation:
PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF SUPERVISORS’ PERSPECTIVE AND EMPLOYEE OUTCOMES
Diana Boyd Powell,
Doctor of Business Administration, 2023
PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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Abstract
Presenteeism or sickness presenteeism was defined by Johns (2010) as “attending work while ill,” and other authors have posited that “sickness presenteeism” refers to a continued presence at work despite a health condition. This dissertation examined best practices for supervising employees with health conditions and presenteeism. Presenteeism increases costs for employers through decreased productivity, high turnover rates, and increased healthcare expenses. Because presenteeism is a global phenomenon, there is a need to explore the best method supervisors can use to manage employees with health conditions and presenteeism. This systematic review of 45 quality-appraised articles via the Mixed Methods Appraisal Tool explored factors that affected individual health and its impact on the job. Managerial work-related factors, roles, communication, and the work environment impact the employee’s health and presenteeism. This dissertation also explored ways to manage employees effectively and efficiently with health conditions and presenteeism; it focused on the supervisor-employee relationship and the supervisor’s role in the process. This qualitative study showed that employees with health conditions and presenteeism did impact the workplace and that managerial factors, including leadership style, relationships, job role, and demographics, affected employees with health conditions and presenteeism. Organizational rules and regulations that managers or supervisors apply also affected employees’ presenteeism. Costs due to work-related problems and rewards played a role in presenteeism. Communications from supervisors and coworkers and disclosure of one’s disability or illness helped supervisors better ascertain avenues for employee accommodations. Building relationships with coworkers, colleagues, supervisor(s), and family assured social support for the worker. The effect of employee health conditions and presenteeism PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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calls for additional research in aligning strategies that can be applied within different organizations and industries. It also calls for exploring if/how knowledge of a presenteeism culture brings awareness and training to leadership, management, staff, supervisors, colleagues, and coworkers on the impacts of employee presenteeism.
Keywords: presenteeism, supervision, health, worker
PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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BREAK
PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF SUPERVISORS’ PERSPECTIVE AND EMPLOYEE OUTCOMES
By
Diana Boyd Powell
Dissertation submitted to the School of Business,
University of Maryland Global Campus, in partial fulfillment
of the requirements for the degree of
Doctor of Business Administration
2023
PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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© Copyright by
[Diana Boyd Powell]
2023
PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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Dedication
I am grateful to have gone through this process and completed this dissertation. I am most thankful to an extraordinary God for carrying me through this dissertation, as I could not have done so alone. When there were good and bad days, I looked at the sticky notes on my desktop that read, “God’s grace is sufficient, and I can do all things through Christ that strengthens me.” Not only Christ brings strength, but as quoted by Nelson Mandela, “Education is the most powerful weapon which you can use to change the world” (Mandela, 2019).
This dissertation is a dedication to many remarkable and influential people in my life. First, I would like to dedicate all that I am and have accomplished to my late parents, Bunnie J. and Johnny J. Boyd, who cannot witness my accomplishments. However, my parents taught me that if you put God first in all you do, be kind, and treat people with dignity and respect, you can accomplish anything you want. I live by those words and the words of a wise man, my father, who taught me perseverance and instilled in our family these words, “You may give out, but do not give up.”
Second, I would like to dedicate this dissertation to my husband (Gene D. Powell, Sr.) and two children (Gene D. Powell, Jr. and Bianca K. Powell). Thank you for your unconditional love and for believing in me. To my husband, thank you for staying up late nights into early mornings, for your support and understanding, for running my errands, cooking our meals, praying for our family, and wiping my tears with a warm embrace. Thank you to my incredible children for always loving me. Your encouragement, prayers, telephone calls, emails, sticky notes with words of wisdom, and technical support pushed me through this incredible process, especially when I had no energy left. Most of all, thank you for believing in me and PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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giving me my new catchphrase, “You have got this!” A special thank you to my niece (Robin D. Davis). You always were available to listen and support me throughout this process; I am forever grateful.
Third, I would be remiss if I did not mention my Maltipoo, “Lady,” who spent every day and every night with me, never complaining in the roles of protector and companion and providing lots of kisses and socialization. She is a mutually beneficial friend, weighing only 10 pounds.
Fourth, thanks to my best friend, Deborah A. Mason, my closest friend, Karen M. Foreman, my siblings (Rose, Mary, Carrie, and Frank), and my nephew Bernard and family, Earlene and Kiyah Boyd, for your prayers and support. Every word of encouragement was received and treasured. A special thank you to my cousin and friend (Mary L. Stallings). Your beautiful and endearing phone calls, text messages, and words of wisdom lifted my spirits and encouraged me daily.
Finally, thanks to the DBA chair, faculty, staff, and cohort for their uncandid and unwavering support, emails, telephone calls, words of wisdom, and encouragement. PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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Acknowledgments
I praise and acknowledge my husband (Gene D. Powell, Sr.) and children (Gene D. Powell, Jr. and Bianca K. Powell) for their unconditional love and support on my DBA program journey. Members of my family (Gordon McDowell and my children) who provided a general reading of my dissertation, thank you for your input; it is appreciatively acknowledged.
I am grateful for and acknowledge the valuable guidance and support from my mentors, Dr. Kathleen Edwards (primary) and Dr. Marcia Bouchard. Dr. Edwards, thank you for keeping me grounded on target and for the valuable lessons you shared during this journey. The journey was challenging, exciting, sad with life happenings, and even scary; however, you kept me on target and taught me how to think differently, contributing to my personal growth. Your knowledge during this journey was relentless, and I could not have done this alone; I genuinely appreciate our time together. As I journey through my dissertation, I will remember “moving like the wind.” The journey is like the wind, as the wind only makes a sound when it comes in contact with an object. I am the object; you were the wind in my dissertation journey, and I heard you clearly as you guided me through the process. The task was not easy, especially with the “blue sky writer.”
Dr. Bouchard, you have played a role in this journey before and during my dissertation process, and I am sincerely appreciative. I want to acknowledge the kindness, knowledge imparted, Looms, and words of encouragement throughout this journey and, most of all, for understanding that life happens. You opened the doors to the dissertation process and imparted knowledge that led us to this pathway. I want to acknowledge the UMGC DBA Reference Librarian, Ms. Cynthia Thomes, for sharing her knowledge of APA guidelines and, of course, the “search string” that allowed me to locate the studies needed to complete my dissertation. I would PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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also like to acknowledge Dr. Denise Breckon, DBA course mentor and Collegiate Faculty, for all the work and insight she provided during her time with the cohort and words of wisdom. I would like to equally acknowledge Ms. Marina Caminis, Academic Program Coordinator for the DBA program, for her relentless coordination and for wearing multiple hats to bring the DBA program activities together. I would also like to acknowledge a former UMGC faculty member, Dr. Wanda Wagner, for her kindness, smiles, the knowledge she imparted regarding understanding the dissertation process, and of course, being the whiz at “ATLAS.ti and other software programs.
PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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Table of Contents
Abstract .................................................................................................................................... ii
PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF SUPERVISORS’ PERSPECTIVE AND EMPLOYEE OUTCOMES ......................................................................v
Dedication ............................................................................................................................... vii
Acknowledgments ..................................................................................................................... ix
Table of Contents ...................................................................................................................... xi
List of Tables ...........................................................................................................................xiv
List of Figures ........................................................................................................................... xv
Chapter 1: Introduction and Overview of the Management Problem .......................................... 16
Chapter 1 Organization .......................................................................................................... 17
Background and Overview .................................................................................................... 18
Problem Statement and Significance of the Problem .............................................................. 21
Presenteeism as a Work-Related Problem .............................................................................. 22
Aging’s Impact on Performance ......................................................................................... 23
Impact of Alcohol Consumption and Presenteeism ............................................................. 23
Impact on the Workplace Before and After COVID-19 ...................................................... 25
A Problem Conclusion and Plan ......................................................................................... 28
Purpose of the Study and The Research Question .................................................................. 30
Research Question ............................................................................................................. 31
Rationale for the Study or Significance of the Study .............................................................. 31
Discussion of Concepts .......................................................................................................... 32
Chronic Health Conditions ................................................................................................. 32
Other Diseases and Conditions ........................................................................................... 33
Productivity ....................................................................................................................... 33
Supervisory Support ........................................................................................................... 34
Work Behavior and its Theoretical Support ........................................................................ 34
Work Relationships ............................................................................................................ 36
Definitions and Terminology ................................................................................................. 37
Communicable disease ....................................................................................................... 37
Distress: ............................................................................................................................. 37
Noncommunicable disease ................................................................................................. 38
Chapter Summary .................................................................................................................. 38
Organization of the Dissertation ............................................................................................ 39
Chapter 2: Scoping Literature Review and Theoretical Frame ................................................... 40
Introduction to Chapter 2 ....................................................................................................... 40
Theoretical Framework .......................................................................................................... 41
Exchange Relationships ..................................................................................................... 42
Cost-Benefit Analysis ........................................................................................................ 43 PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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Reward/Benefit (Mutual Trust) .......................................................................................... 44
Exchange Expectancy ........................................................................................................ 44
Scoping Literature Review .................................................................................................... 45
Social Exchange Theory’s Origins and Other Theories .......................................................... 46
Conceptual Framework .......................................................................................................... 49
Initial Conceptual Model .................................................................................................... 49
Cost-Benefit ....................................................................................................................... 51
Trust ................................................................................................................................. 52
Workplace and Health Factors ............................................................................................... 53
Productivity Loss ............................................................................................................... 53
Work-life Balance (WLB) .................................................................................................. 53
Health Conditions .............................................................................................................. 54
Supervisory Support ........................................................................................................... 54
Social Exchange Relationships ........................................................................................... 55
Social Expectation ............................................................................................................. 55
Outcome (Demonstration of Ways to Deal with Presenteeism) ........................................... 56
Chapter Summary .................................................................................................................. 56
Chapter 3: Method .................................................................................................................... 58
Introduction to Chapter 3 ....................................................................................................... 58
Review Design and Methodology .......................................................................................... 58
The Evidence-Based Research Framework ......................................................................... 60
Systematic Reviews ........................................................................................................... 60
Systematic Review Process ................................................................................................ 61
Search Strategy .................................................................................................................. 63
Database Aggregator and Databases Searched .................................................................... 64
PRISMA Diagram .............................................................................................................. 64
Study Selection .................................................................................................................. 65
Search Process and Terms ..................................................................................................... 66
Reporting and Using the Results ............................................................................................ 67
Method of Quality Appraisal of the Included Studies ......................................................... 67
CERQual ........................................................................................................................... 69
Analysis and Synthesis Methodology..................................................................................... 69
Chapter Summary .................................................................................................................. 72
Chapter 4: Analysis and Findings .............................................................................................. 73
Introduction to Chapter 4 ....................................................................................................... 73
Review of the Research Question .......................................................................................... 73
Description of the Data Selection ........................................................................................... 73
Coding ............................................................................................................................... 75
Findings and Discussion ........................................................................................................ 76
Theme 1 Impact of Individual Health Conditions on the Employee and Organization ......... 76
Theme 2 Organizational Factors and the Role of Manager/Supervisor ................................ 80
Theme 3 Presenteeism’s Effects on Productivity ................................................................ 94
Theme 4 Socialization and Support for Workers with A Chronic Condition ....................... 96 PRESENTEEISM IN THE WORKPLACE: AN EXPLORATION OF
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Revised Conceptual Model/Framework ............................................................................... 101
Chapter Summary ........................................................................................................
Health and wellness: It is good for business
No full textHealth and wellness programs (HWPs) are efforts by employers to promote the health and wellbeing of employees and address the decreased productivity and increased costs to organizations
resulting from poor employee health conditions. Despite widespread offerings, participation in
HWPs remains low, and the health of U.S. employees continues to decline at a cost to employers.
Through the theoretical frameworks of Theory Z and the Spillover Theory, this study investigated
how HWPs impact employee productivity and organizational performance. A qualitative
systematic review explained how HWPs increased employee productivity and organizational
performance and identified three effective elements in the program design and implementation:
(a) the support by a culture of health and wellness; (b) integration into the organization’s system;
and (c) a comprehensive program design. In turn, HWPs can lead employees to avoid harmful
behaviors and practice healthier behaviors that support mental, physical, and social health,
subsequently impacting overall well-being and increasing productivity and organizational
performance.HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS i
Abstract
Title of Dissertation:
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS
Tanisha Clarke,
Doctor of Business Administration, 2022
Health and wellness programs (HWPs) are efforts by employers to promote the health and well-being of employees and address the decreased productivity and increased costs to organizations resulting from poor employee health conditions. Despite widespread offerings, participation in HWPs remains low, and the health of U.S. employees continues to decline at a cost to employers. Through the theoretical frameworks of Theory Z and the Spillover Theory, this study investigated how HWPs impact employee productivity and organizational performance. A qualitative systematic review explained how HWPs increased employee productivity and organizational performance and identified three effective elements in the program design and implementation: (a) the support by a culture of health and wellness; (b) integration into the organization’s system; and (c) a comprehensive program design. In turn, HWPs can lead employees to avoid harmful behaviors and practice healthier behaviors that support mental, physical, and social health, subsequently impacting overall well-being and increasing productivity and organizational performance.
Keywords: health and wellness program, employee health, productivity, profitability, organizational performance
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS ii
Health and Wellness: It Is Good for Business
By
Tanisha Clarke
Dissertation submitted to the School of Business,
University of Maryland Global Campus, in partial fulfillment
of the requirements for the degree of
Doctor of Business Administration
2022 HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS iii
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS iv
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS v
© Copyright by
Tanisha Clarke
2022
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS vi
Dedication
Cheers to an expected end!
It is a joy to walk into the plan that was set out for me - plans of hope and a future.
Thank you, Daddy!
I dedicate this dissertation to my daughter, Janayah, whom I love beyond measure. Thank you for taking this journey with me. It has not been easy, and I owe you lots of home-cooked dinners, but your love, patience, independence, self-sufficiency, and support meant everything to me. I am so proud of you, and I can’t wait to see all that God has in store for you.
… to God - to me - to you - This is for us!
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS vii
Acknowledgments
I would like to acknowledge and give thanks to my defense committee. First, my professor and primary mentor, Dr. Schuyler Jarrow. Dr. Jarrow, words cannot express my appreciation for your invaluable guidance, support, and feedback. It was a long and emotional process, but you stuck with me to the finish line. They say, “it’s not how you start that’s important, but how you finish!” We sure proved that to be true, and I am certainly glad to finish with you. Thank you for believing in me! To my secondary mentor, Dr. James Gelatt, your feedback and questions sometimes stomped me, but they also pushed me to go deeper or clarify further, ultimately for the betterment of my dissertation.
Dr. Bob, thank you for keeping your word. Despite your busy schedule, you invested your time in me. I am grateful for your review and insights. I also appreciated your cheering me on and your encouragement to keep going. Your kindness is unmatchable! To all my other DBA professors and staff, thank you for sharing your knowledge, expertise, and help along the way. Cynthia, you are a wiz, and my research would not be what it is without your help. Dr. Ellie, thank you for your editing assistance. And what an amazing cohort! We did it, guys!
I have been blessed to cross paths with some amazing mentors and colleagues over the course of my academic and professional career. You helped me find my voice and chart the course. I am thankful to each and every one of you! A dear shout out to Donna and Tawara.
Thank you to my family and friends – near and far – who encouraged me throughout my doctoral journey. Some of you started with me when this was just a dream. Jacy, you helped proofread my personal statement and writing samples for admission into the DBA program, and here we are now. We will celebrate together! HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS viii
A special thanks to my dearest family in the US. My mom’s undying love and connection runs deep. Thank you for always calling and not giving me too much grief when I did not call back. Without your sacrifices, I would never have had this opportunity to pursue my education and obtain my doctorate degree. I am grateful for all the opportunities I have had in my life because of you. Thank you, dad, for the one-on-one conversations that sometimes went on for hours. Our lives are fuller because of you. Thank you for standing in the gaps and loving us as only you can. Thank you, grandma, because you helped raise and nurture me. You created stability for us as mom worked long hours to support the family. My amazing sisters - the epitome of strength and resilience. My little/big brother who says everything without saying a word. To my nieces and nephews, you continue to make me proud. Thank you all for your love and prayers. You all mean the world to me.
I would also like to thank my family in Jamaica - my roots, my drive. I carry you with me on this journey. Thank you to my GUCC family – friends who became family. And thanks to Kingdom Fellowship for the spiritual guidance and uplift that I needed to carry me through the ups and downs.
Thanks to everyone! The best is yet to come!
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS ix
Table of Contents
Abstract ........................................................................................................................................... i
Health and Wellness: It Is Good for Business ................................................................................ ii
Dedication ..................................................................................................................................... vi
Acknowledgments........................................................................................................................ vii Table of Contents .......................................................................................................................... ix
List of Tables ............................................................................................................................... xiii
List of Figures .............................................................................................................................. xiv
Chapter 1: Introduction and Overview of The Management Problem ........................................... 1
Background and Overview ................................................................................................. 2
Problem Statement and Significance of the Problem ......................................................... 4
Purpose of the Study and The Research Question .............................................................. 6
Significance of the Study .................................................................................................... 7
Definitions and Terminology .............................................................................................. 8
Chapter Summary ............................................................................................................... 9
Organization of the Dissertation ....................................................................................... 10
Chapter 2: Scoping Literature Review and Theoretical Frame .................................................... 11
Theoretical Framework ..................................................................................................... 12
Theory Z...................................................................................................................... 12
Spillover Theory ......................................................................................................... 16 HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS x
The Literature Landscape ................................................................................................. 17
Organizational Performance ....................................................................................... 18
Employee Productivity................................................................................................ 23 Health and Wellness ................................................................................................... 24
Conceptual Framework ..................................................................................................... 30
Chapter Summary ............................................................................................................. 32
Chapter 3: Method ........................................................................................................................ 34
Research Design and Methodology .................................................................................. 34
The Evidence-Based Practice Framework .................................................................. 35
Systematic Reviews .................................................................................................... 35
Systematic Review Process......................................................................................... 35
Search Strategy ........................................................................................................... 36
Method of Quality Appraisal of the Intended Studies ................................................ 40
PRISMA Diagram ....................................................................................................... 45
Analysis and Synthesis Methodology ......................................................................... 45
Chapter Summary ............................................................................................................. 50
Chapter 4: Analysis and Findings ................................................................................................. 51
Review of the Research Question ..................................................................................... 51
Description of the Dataset ................................................................................................. 51
Results of the Quality Appraisal of the Data Set .............................................................. 54 HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS xi
Findings and Discussion ................................................................................................... 55
Theme 1: Culture of Health and Wellness .................................................................. 55
Theme 2: Integrated into the Organization's Systems ................................................ 59
Theme 3: Comprehensive Program Design ................................................................ 62
Summary of Findings ........................................................................................................ 65
Revised Conceptual Model/Framework ........................................................................... 66
Chapter Summary ............................................................................................................. 67
Chapter 5: Conclusions and Implications ..................................................................................... 68
Review of the Research .................................................................................................... 68
Research Process ......................................................................................................... 69
Search String Development ........................................................................................ 69
Coding and Synthesis .................................................................................................. 69
Answer to the Research Question ..................................................................................... 70
Management Implications ................................................................................................. 71
Culture of Health and Wellness .................................................................................. 73
Integration into the Organization's Systems ............................................................... 74
Comprehensive Program Design ................................................................................ 74
Recommendations for Practitioners .................................................................................. 76
Recommendation 1: Devote Time and Resources to Developing a Culture of Health and Wellness that will Support HWPs ........................................................................ 76 HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS xii
Recommendation 2: Establish Policies that Ensure the Value of Health and Wellness is Embodied and Perceived throughout the Organization and How it does Business. 78
Recommendation 3: Engage Employees in the Process of Developing a Comprehensive Program Design that is Tailored to the Organization ....................... 80
Limitations of the Study.................................................................................................... 81
Areas for Future Research ................................................................................................ 82
Final Summary and Conclusion ........................................................................................ 83
References .................................................................................................................................... 84
Appendix A: Articles' Appraisals Using the TAPUPAS Model as a Benchmark Tool ............... 97
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS xiii
List of Tables
Table 1 Elements of Theory Z ...................................................................................................... 15
Table 2 Key Findings of Workplace Health in America on Types of HWPs Offered Nationwide 30
Table 3 Search Strings Developed and Used to Retrieve the Best Evidence for this Research ... 37
Table 4 Overall Inclusion and Exclusion Criteria ....................................................................... 38
Table 5 Basic Summary of TAPUPAS Quality Standards Framework ....................................... 41
Table 6 Articles' Appraisals Using the TAPUPAS Model as a Benchmark Tool ........................ 42
Table 7 Articles Included in Qualitative Synthesis ...................................................................... 44
Table 8 Level 1/ Open Coding Results ......................................................................................... 48
Table 9 Level 2/ Descriptive Themes ........................................................................................... 49
Table 10 Level 3/ Analytical Themes ........................................................................................... 50
Table A1 Articles' Appraisals Using the TAPUPAS Model as a Benchmark Tool...................... 97
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS xiv
List of Figures
Figure 1 Conceptual Model.......................................................................................................... 32
Figure 2 PRISMA Flow Diagram documenting this review process. .......................................... 46
Figure 3 PRISMA Flow Diagram documenting this review process. ......................................... 53
Figure 4 Coding results: Level 1 (open coding) to Level 2 (descriptive themes) ........................ 56
Figure 5 Coding results: Level 2 (descriptive themes) to Level 3 (analytical themes). ............... 57
Figure 6 Revised Conceptual Model. ........................................................................................... 67
HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS 1
Chapter 1: Introduction and Overview of The Management Problem
Management research revealed a growing implementation of employer-paid health and wellness programs (HWPs) to combat the declining health of the workforce and increasing cost of healthcare (Drury, 2016; Garrin, 2014; Heninger et al., 2019; Plump & Ketchen Jr, 2013; Smith et al., 2017). Garrin (2014) reported that 67% of American employees battled obesity or comorbid weight-related conditions, which accounted for $73 billion in medical costs and other losses. Many health concerns and costs were because of poor eating habits, unhealthy choices like cigarette smoking, and sedentary lifestyles. Another factor affecting employees is stress. Richardson (2017) reported that “40% of Americans say their job is 'very or extremely stressful', and 29% are 'quite a bit or extremely stressed at work’” (p. 423). The 2020 pandemics further affected employees' physical, mental, and social well-being. Many employees were under lockdown in their homes and isolated with no childcare or psychosocial support. Others saw or experienced violence and injustice. These factors play a role in an employee's health and wellness and their ability to be productive, thereby affecting employers or organizational performance. HWPs “represent efforts by organizations to promote and increase the health and well-being of their employees” (Heninger et al., 2019). While many studies have shown that HWPs impact on-the-job productivity and organizational performance, the pragmatics of how this occurs are mixed, creating questions for management around implementation and effectiveness (Drury, 2016; Garrin, 2014; Heninger et al., 2019; Plump & Ketchen Jr, 2013; Radzi et al., 2020). This study aimed to offer more than a simple discussion of what outcomes organizations have experienced from HWPs. More importantly, my findings also provided insight into the contributing factors that led to these positive outcomes. HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS 2
Background and Overview
The U.S. Office of Personnel Management [OPM] (2022) stated that “the leading causes of death and disability in the United States are not only preventable but also responsive to workplace interventions” (para. 1). For millions of employees, a third or more of their day is on the job. For those with desk jobs, a third of their day is sedentary, further exacerbating their poor health practices or conditions. Approximately “85% of the United States healthcare expenditures are due to sedentary lifestyles, poor nutrition, and cigarette smoking and attributed to over two-thirds of all chronic diseases” (Miller, 2021, p. 110). There is growing importance for organizations to set up workplace interventions, such as HWPs, that promote and support their employees' health and wellness, considering the rising health concerns, aging workforce, growing demand for work-life balance, and need for organizations to remain competitive (Lahoz & Camarotto, 2012; Nyanga & Sibanda, 2019). Evidence suggested that HWPs can (a) yield savings in health costs, (b) reduce absenteeism and turnover, (c) increase employee motivation, engagement, and performance, and (d) improve employee recruitment (Drury, 2016; Garrin, 2014; Heninger et al., 2019; Plump & Ketchen Jr, 2013; Radzi et al., 2020). Organizations are positioned to and can benefit from offering HWPs because a healthy employee benefits both the individual and the organization.
Employers can say that an employee's health and wellness are not the employer's responsibility. An employer may operate under the notion that people need to work or choose to work and should therefore make the necessary choices that will allow them to show up to work ready to produce. However, according to Chandra (2012): HEALTH AND WELLNESS: IT IS GOOD FOR BUSINESS 3
Work though central is only one of the several interests that human beings pursue in life. When the demands of work hamper the pursuit of other life interests, it is likely to create a crisis and the resultant stresses and strains among the employees. (p. 1040)
These stresses and strains can have:
Adverse effects on workers' mental health, with an increased risk of anxiety, burnout, depression, and substance use disorders. Workers who are stressed at work are more likely to engage in unhealthy behaviors, such as cigarette smoking, alcohol and drug abuse, and poor dietary patterns. (Corporate Wellness Magazine, 2022, para
Decision support systems for business continuity of U.S. critical transportation infrastructure: A systematic review
No full textThe critical transportation infrastructure (CTI) that society relies on to be constantly available, including
but not limited to bridges, tunnels, limited access highways, and associated assets, is under increasing
demand and the consequent threat of disruption. Whether it is a cyberattack or a natural disaster
threatening to interrupt service, business continuity managers have many choices about protecting the
essential airways, railways, and roadways that are also integral parts of national preparedness efforts
and defense. Floods, fires, terrorism, pandemics, and technical accidents all highlight the need for
continuity managers to better plan for disasters and efficiently recover from them. The research
question guiding this dissertation is: What decision support systems should managers incorporate into
their business continuity plans to protect critical transportation infrastructure against disruption in the
United States? The findings indicated that decision support systems (DSS) would aid managerial
decision-making where time is of the essence in an emergency. However, specific data inputs are
required. Furthermore, collaboration as a disruption mitigation strategy is explored. Presented as a
systematic review, the theoretical framework for this study was created using the theory of absorptive
capacity and high reliability organization theory.Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure i
ABSTRACT
Title of Dissertation:
DECISION SUPPORT SYSTEMS FOR BUSINESS CONTINUITY OF U.S. CRITICAL TRANSPORTATION INFRASTRUCTURE: A SYSTEMATIC REVIEW
Michael Arthur Quintieri
Doctor of Business Administration, 2022
The critical transportation infrastructure (CTI) that society relies on to be constantly available, including but not limited to bridges, tunnels, limited access highways, and associated assets, is under increasing demand and the consequent threat of disruption. Whether it is a cyberattack or a natural disaster threatening to interrupt service, business continuity managers have many choices about protecting the essential airways, railways, and roadways that are also integral parts of national preparedness efforts and defense. Floods, fires, terrorism, pandemics, and technical accidents all highlight the need for continuity managers to better plan for disasters and efficiently recover from them. The research question guiding this dissertation is: What decision support systems should managers incorporate into their business continuity plans to protect critical transportation infrastructure against disruption in the United States? The findings indicated that decision support systems (DSS) would aid managerial decision-making where time is of the essence in an emergency. However, specific data inputs are required. Furthermore, collaboration as a disruption mitigation strategy is explored. Presented as a systematic review, the theoretical framework for this study was created using the theory of absorptive capacity and high reliability organization theory. Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
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Keywords: Decision support systems, business continuity, critical infrastructure, transportation, absorptive capacity, high reliability organization
Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
iii
DECISION SUPPORT SYSTEMS FOR BUSINESS CONTINUITY OF U.S. CRITICAL TRANSPORTATION INFRASTRUCTURE: A SYSTEMATIC REVIEW
By
Michael Arthur Quintieri
Dr. Deborah Wharff, Primary Advisor
Dr. Denise Breckon, Secondary Advisor
Dissertation submitted to the School of Business,
University of Maryland Global Campus, in partial fulfillment
of the requirements for the degree of
Doctor of Business Administration
2022
Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
iv
© Copyright by
Michael Arthur Quintieri
2022
Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
v
Dedication
This dissertation is dedicated to Dr. Anthony J. Robb who inspired me to pursue so much. Tony was a learned scholar and traveler in addition to being an esteemed language professor. He taught me I was capable and to believe in possibility, subtly but aptly as was his way. Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
vi
Acknowledgements
My spouse, Frank, was unwavering throughout this process and deserves a special set of accolades. Special thanks to Dr. Deborah Wharff and Dr. Denise Breckon. I could not have made it this far without your support and encouragement. I will do my upmost best to carry your words of wisdom forward.
Additionally, special thanks goes to the following individuals and places that shaped the journey:
Dr. Aminu Jibrin – Aurora, CO
Ayo Yejide – Kansas City, MO
Barbara Reis, Anthony Pumphrey, Joe Quintieri (dec.) – Philadelphia, PA
Brett J. Mattei – St. Petersburg, FL
Daniel Quintana – Westwood, NJ
Dominic Starelli – Pacifica, CA
Esteban Cabezzas Villalobos – San José, Costa Rica
Francesco Quintieri – Milan, Italy
Dr. Gerard A. LaMorte III – Rutgers University—Newark
Joe Consolo (dec.) – Chesterfield, MO
John Giordano – Voorhees, NJ
Dr. Kendal García Humes – Alamosa, CO
Maryann Miller – Medford, NJ
Nicholas J. Basile, Joy Pino-Mottin, and Alyssa Little – Washington Township, NJ
Nigel Soloman – Toronto, Canada
Richard Kennedy – Maple Shade, NJ
Tara Roseman – Sherman Oaks, CA
Thomas André – Paris, France Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
vii
Table of Contents
Abstract .......................................................................................................... Error! Bookmark not defined.
DECISION SUPPORT SYSTEMS FOR BUSINESS CONTINUITY OF U.S. CRITICAL TRANSPORTATION INFRASTRUCTURE: A SYSTEMATIC REVIEW ................................................................................................. iii
Dedication .................................................................................................................................................... v
Acknowledgements ..................................................................................................................................... vi
Table of Contents ....................................................................................................................................... vii
Listing of Tables ........................................................................................................................................... ix
Listing of Figures .......................................................................................................................................... x
Chapter 1: Introduction and Overview of the Management Problem ......................................................... 1
Background and Overview ........................................................................................................................... 4
Business Continuity (BC) ....................................................................................................................... 4
Decision Support Systems (DSS) ........................................................................................................... 6
Disruptions to Critical Transportation Infrastructure ........................................................................... 7
Problem Statement and Significance of the Problem ................................................................................. 9
Research Question .............................................................................................................................. 11
Rationale for the Study or Significance of the Study .......................................................................... 13
Definitions and Terminology ...................................................................................................................... 14
Chapter Summary ..................................................................................................................................... 15
Organization of the Dissertation ................................................................................................................ 15
Chapter 2: Scoping Literature Review and Theoretical Frame ................................................................... 16
Discussion of Theoretical Framework ........................................................................................................ 16
Absorptive Capacity ............................................................................................................................ 17
High Reliability Organizations (HROs) ................................................................................................. 19
Scoping Literature Review ......................................................................................................................... 22
Critical Transportation Infrastructure: The Threat Landscape ........................................................... 22
Business Continuity and Information Exchange ................................................................................. 25
Decision Support Systems (DSS) ......................................................................................................... 26
Conceptual Framework .............................................................................................................................. 28
Chapter Summary ..................................................................................................................................... 29
Chapter 3: Methodology ............................................................................................................................. 30
Review Design and Methodology .............................................................................................................. 30
Evidence-Based Management and Research Framework .................................................................. 31
The Systematic Review (SR) ................................................................................................................ 31
Systematic Review (SR) Process .......................................................................................................... 32
Scoping Process and Research Question Review (Asking) .................................................................. 32
Search Strategy to Identify Relevant Evidence (Acquiring) ................................................................ 33
PRISMA Diagram ................................................................................................................................ 33
Inclusion and Exclusion Criteria .......................................................................................................... 35
Method for Quality Appraisal of the Dataset (Appraising) ................................................................. 36
Analysis and Method of Synthesis (Aggregating) ............................................................................... 37 Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
viii
Findings and Recommendations (Applying and Assessing) ................................................................ 38
Coding Process ................................................................................................................................... 38
Chapter Summary ..................................................................................................................................... 38
Chapter 4: Analysis and Findings ................................................................................................................ 40
Review of the Research Question .............................................................................................................. 40
Description of the Dataset ......................................................................................................................... 41
Screening Results ............................................................................................................................... 41
Results of the Quality Appraisal of the Dataset ......................................................................................... 42
Quality Appraisal Results .................................................................................................................... 42
Final PRISMA Details ........................................................................................................................... 43
Date Extraction Process ............................................................................................................................. 45
Publication Data ................................................................................................................................. 45
Identification of Gray Literature ......................................................................................................... 46
Coding Process Results .............................................................................................................................. 47
Findings and Discussion ............................................................................................................................. 49
Finding 1: Decision support systems (DSS) can be defined in a multitude of ways. .......................... 50
Finding 2: Business continuity (BC) depends on the use of an effective decision support system (DSS). .................................................................................................................................................. 54
Finding 3: DSS require various high-quality data inputs. .................................................................... 57
Finding 4: Collaboration was found to mitigate disruption. ............................................................... 58
Finding 5: The increasing of dynamic capabilities was found to contribute positively to disruption prevention/business continuity. ......................................................................................................... 60
Summary of Findings ................................................................................................................................. 63
Revised Conceptual Model/Framework .................................................................................................... 63
Chapter Summary ..................................................................................................................................... 64
Chapter 5: Conclusions and Implications .................................................................................................... 66
Significance of the Research ...................................................................................................................... 66
Answer to the Research Question ............................................................................................................. 67
Management Implications and Recommendations .................................................................................. 69
Recommendation 1: Managers must identify and re-identify risk as they continually refine their BCP. .................................................................................................................................................... 70
Recommendation 2: Consider data needs and interdependencies simultaneously. ......................... 71
Recommendation 3: Develop and increase dynamic capabilities to increase BC likelihood. ............. 72
Recommendation 4: Incorporate a DSS relevant to the CTI and readjust plans constantly. ............. 73
Limitations of the Study ............................................................................................................................. 74
Areas for Future Research ......................................................................................................................... 75
Final Summary and Conclusion .................................................................................................................. 75
References ................................................................................................................................................. 77
Appendix A ................................................................................................................................................. 91
Appendix B ................................................................................................................................................. 93
Appendix C ................................................................................................................................................. 95
Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
ix
Listing of Tables
Table 1 .......................................................................................................................................................... 8
Table 2 ........................................................................................................................................................ 12
Table 3 ........................................................................................................................................................ 14
Table 4 ........................................................................................................................................................ 21
Table 5 ........................................................................................................................................................ 35
Table 6 ........................................................................................................................................................ 43
Table 7 ........................................................................................................................................................ 45
Table 8 ........................................................................................................................................................ 45
Table 9 ........................................................................................................................................................ 47
Table 10 ...................................................................................................................................................... 48
Table 11 ...................................................................................................................................................... 49
Table 12 ...................................................................................................................................................... 51
Table 13 ...................................................................................................................................................... 55
Table 14 ...................................................................................................................................................... 57
Table 15 ...................................................................................................................................................... 60
Table 16 ...................................................................................................................................................... 62
Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
x
Listing of Figures
Figure 1 ........................................................................................................................................................ 7
Figure 2 ...................................................................................................................................................... 17
Figure 3 ...................................................................................................................................................... 28
Figure 5 ...................................................................................................................................................... 37
Figure 6 ...................................................................................................................................................... 44
Figure 7 ...................................................................................................................................................... 64
Figure 8 ...................................................................................................................................................... 69 Decision Support Systems for Business Continuity of U.S. Critical Transportation Infrastructure
1
Chapter 1: Introduction and Overview of the Management Problem
The Cybersecurity and Infrastructure Security Agency (CISA) defines critical infrastructure (CI) as “sectors whose assets, systems, and networks, whether physical or virtual, are considered so vital to the United States that their incapacitation or destruction would have a debilitating effect on security, national economic security, national public health or safety, or any combination thereof” (National Mining Association, 2020, para. 3). In what Galbusera et al. (2021) refer to as the nervous system of our collective societies, there are 1
What are the management strategies to promote work-life balance for hybrid teams? A systematic review
No full textThe study provides a strategic management framework based on two scientific theories using a
systematic literature review of management strategies that promote work-life balance. This study
explores organizational culture, processes, and leadership efforts in establishing a practical management
framework for work-life balance support in hybrid teams model environment. Method: The study is a
systematic literature review conducted using IGI Global, ScienceDirect, ResearchGate, Web of Science,
SCOPUS, CORE, GoogleScholar, and UMGC electronic databases. Data covers the period from 2000 to
2022, narrowed to publications written in English. Results: The results indicate the systemic integration
of organizational culture, leadership, and technology implementations that must be applied together for
a process to be successful. Conclusions: While the hybrid work model environment benefits modern
organizations and has earned its place in the future, specific management strategies need to support
organizational optimization in a new environment. Limitations: The interest of this study is management
strategies that impact work-life balance in a hybrid model team. Nevertheless, much of the research
literature concentrates either on management strategies, work-life balance, or hybrid teams but not on
the combined focus of this study, which represents a limitation of this study. Originality/value: The
study introduced a new knowledge area into the current literature related to management strategies
based on the combined focus of work-life balance and hybrid teams. The results may help managers to
establish the workflow and organizational policies supporting employers’ work-life balance in hybrid
teams.MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS i
Abstract
Title of Dissertation:
WHAT ARE THE MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS? A SYSTEMATIC REVIEW
Alla Levin,
Doctor of Business Administration, 2022
The study provides a strategic management framework based on two scientific theories using a systematic literature review of management strategies that promote work-life balance. This study explores organizational culture, processes, and leadership efforts in establishing a practical management framework for work-life balance support in hybrid teams model environment. Method: The study is a systematic literature review conducted using IGI Global, ScienceDirect, ResearchGate, Web of Science, SCOPUS, CORE, GoogleScholar, and UMGC electronic databases. Data covers the period from 2000 to 2022, narrowed to publications written in English. Results: The results indicate the systemic integration of organizational culture, leadership, and technology implementations that must be applied together for a process to be successful. Conclusions: While the hybrid work model environment benefits modern organizations and has earned its place in the future, specific management strategies need to support MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
ii
organizational optimization in a new environment. Limitations: The interest of this study is management strategies that impact work-life balance in a hybrid model team. Nevertheless, much of the research literature concentrates either on management strategies, work-life balance, or hybrid teams but not on the combined focus of this study, which represents a limitation of this study. Originality/value: The study introduced a new knowledge area into the current literature related to management strategies based on the combined focus of work-life balance and hybrid teams. The results may help managers to establish the workflow and organizational policies supporting employers’ work-life balance in hybrid teams.
Keywords: work-life balance, hybrid teams, management strategies, organizational culture, technology, communication.
MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
iii
WHAT ARE THE MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS? A SYSTEMATIC REVIEW
By
Alla Levin
Dissertation submitted to the School of Business,
University of Maryland Global Campus, in partial fulfillment
of the requirements for the degree of
Doctor of Business Administration
2022
MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
iv
© Copyright by
Alla Levin
2022
MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
v
Dedication
I dedicate my study work to my children, Benjamin and Alexandra Levin-Lozovatsky. You inspired me to go to school again by saying, "We are not smart enough to be a doctor." I want you to know: even if you would not become a doctor, you should always know that you are smart enough to be one. I'm very proud of you two and will spend the rest of my life learning from you. No matter how many significant accomplishments I can make in my life, you are always the most important achievement of my life.
A special thanks to my wife, Elena Levin-Lozovatsky, who said I do not need to do it but kept supporting me by taking care of our children when I couldn't.
I also want to dedicate this work to my parents, Holocaust-survivors kids: my deceased Mom, Khaya Levin, who told me that women only get grief and trouble from too much education; and my Dad, Nema Levin, who never learned to write in any language, who could not help me with my homework, but always said that education is the most important thing, and I have to know more than others to survive in this life. Dad, thank you for saying it to my children now too. They do listen.
Lastly, I dedicate this study to my dog, English springer spaniel (kind of) Ari, and my cat, Maine Coon King Solomon (aka Monya). They were always by my side to comfort me when I was locking myself and quietly crying in the room in frustration and ready to quit. MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
vi
Table of Contents
Abstract ......................................................................................................................................................... i
Dedication .................................................................................................................................................... v
Table of Contents ........................................................................................................................................ vi
List of Tables ............................................................................................................................................. viii
List of Figures .............................................................................................................................................. ix
Chapter 1: Introduction and Overview of the Management Problem ......................................................... 1
Background and Overview........................................................................................................................ 2
Problem Statement and Significance of the Problem ................................................................................ 4
Purpose of the Study and The Research Question .................................................................................... 5
Significance of Study ................................................................................................................................ 6
Definitions and Terminology ..................................................................................................................... 7
Chapter Summary and Organization of the Study ........................................................................................ 8
Chapter 2: Scoping Literature Review and Theoretical Frame ................................................................... 10
The Literature Landscape or Scoping Literature Review ......................................................................... 10
Work-Life Balance ............................................................................................................................... 10
Hybrid Teams ..................................................................................................................................... 12
Technology & Communication ............................................................................................................ 13
Organizational Culture ........................................................................................................................ 14
Management Strategies ..................................................................................................................... 16
Theoretical Framework ........................................................................................................................... 18
Border Theory ..................................................................................................................................... 18
Institutional Theory of Organization ................................................................................................... 20
Conceptual Framework ........................................................................................................................... 21
Chapter Summary ...................................................................................................................................... 22
Chapter 3: Method ..................................................................................................................................... 24
Review Design and Methodology ............................................................................................................ 24
The Evidence-Based Research Framework .......................................................................................... 25
Systematic Review ............................................................................................................................... 25
Search Initiation ................................................................................................................................. 28
Review Question and Methodology .................................................................................................... 28
Inclusion Criteria .................................................................................................................................... 30
Exclusion Criteria .................................................................................................................................... 30
Search Strategy .................................................................................................................................. 30
Method of Quality Appraisal of the Included Studies ......................................................................... 32
PRISMA diagram ................................................................................................................................ 34
Analysis and Synthesis Methodology ...................................................................................................... 36
Coding Process ................................................................................................................................... 36
Chapter Summary ...................................................................................................................................... 41
Chapter 4: Analysis and Findings ................................................................................................................ 43 MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
vii
Review of the Research Question............................................................................................................ 43
Description of the Data Set ..................................................................................................................... 43
Results of the Quality Appraisal of the Data Set ...................................................................................... 44
Findings and Discussion ........................................................................................................................... 50
1. Organizational culture impacts work-life balance management strategies ................................... 50
2. Hybrid Teams model impact on work-life balance management strategies .................................. 53
3. Technology impact on work-life balance management strategies ................................................. 56
Summary ................................................................................................................................................ 58
Revised Conceptual Model/Framework .................................................................................................. 59
Chapter Summary ...................................................................................................................................... 61
Chapter 5: Recommendations, Conclusions and Implications ................................................................... 62
Review of the Research ........................................................................................................................... 62
Answer to the Research Question ........................................................................................................... 63
Management Strategies Recommendations ........................................................................................... 63
1. Management Skills .......................................................................................................................... 64
2. Hybrid Model Team Management .............................................................................................. 70
3. Technology Management ........................................................................................................... 76
Limitations of the Study .......................................................................................................................... 80
Areas for Future Research ....................................................................................................................... 80
Final Summary and Conclusion ............................................................................................................... 82
References ................................................................................................................................................. 83
Appendix A ............................................................................................................................................... 145
Appendix B ............................................................................................................................................... 173
Appendix C ............................................................................................................................................... 174
Appendix D ............................................................................................................................................... 175
Appendix E ............................................................................................................................................... 176
Appendix F ............................................................................................................................................... 177
Appendix G ............................................................................................................................................... 178
Appendix H ............................................................................................................................................... 181
Appendix I ................................................................................................................................................ 182
Appendix J ................................................................................................................................................ 206
Appendix K ............................................................................................................................................... 208
Appendix L ................................................................................................................................................ 209
MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
viii
List of Tables
Table 1 PICOC Method of a Research Question ........................................................................................... 6
Table 2 Inclusion and Exclusion Criteria ................................................................................................... 145
Table 3 TAPUPAS Framework Dimensions ................................................................................................. 33
Table 4 TAPUPAS Criteria and Rating Scales ......................................................................................... 1453
Table 5 Weight of Evidence ........................................................................................................................ 35
Table 6 Appendix A. Characteristics of the Selected Articles Included in the Analysis. Level One. Open Coding ...................................................................................................................................................... 148
Table 7 Appendix G. Categorization. Level Two. Focused Coding. ........................................................... 181
Table 8 Appendix I. TAPUPAS evaluation for selected final 41 articles ................................................... 185
Table 9 Appendix J. WoE evaluation for selected final 41 articles ........................................................... 209
Table 10 Appendix K. Search Strings......................................................................................................... 211
Table 11 Appendix L. Final 41 articles selected with WoE ....................................................................... 212
MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
ix
List of Figures
Figure 1 Border Theory Framework ........................................................................................................... 20
Figure 2 Institutional Theory of the Organization Framework .................................................................. 21
Figure 3 Conceptual Framework ................................................................................................................ 23
Figure 4 The PRISMA Flow Diagram .......................................................................................................... 23
Figure 5 Qualitative Data Levels of Coding ................................................................................................. 37
Figure 6 Categorization. Level One. Open Coding Part 1. Work-Life Balance ............................................ 39
Figure 7 Categorization. Level One. Open Coding Part 2. Management Strategies .................................. 39
Figure 8 Categorization. Level One. Open Coding Part 3. Hybrid Teams ................................................... 40
Figure 9 Categorization. Level One. Open Coding Part 4. Organizational Culture ..................................... 40
Figure 10 Categorization. Level One. Open Coding Part 5. Technology ..................................................... 41
Figure 11 Categorization. Level Three. Axial/Thematic Coding .................................................................. 42
MANAGEMENT STRATEGIES TO PROMOTE WORK-LIFE BALANCE FOR HYBRID TEAMS
1
Chapter 1: Introduction and Overview of the Management Problem
Employee and organizational issues related to work-life balance, such as employee stress and burnout, resulting in decreased productivity and increased staff turnover, have been on the frontline for decades (Deery, 2008). Separating work and home has progressively grown, becoming especially visible during the Covid-19 pandemic, when the abrupt office closure forces people to work from home (Hjálmsdóttir et al., 2021). The boundary between people's work and personal lives has blurred (Hennekam et al., 2021; Pluut et al., 2020).
Companies took the shutdowns as an opportunity to re-evaluate their operational strategies and change workplaces to fit a new work environment, one that can be adapted for a long-term approach (Green et al., 2010; Souppaya et al., 2016). Dealing with the financial implications of the pandemic market caused by funding reductions and staff relocations, organizations were also looking for ways to recover damages by cutting real estate costs, resulting in the need to modify teams' structures. Employees were forced to adopt a new remote working environment, create home offices, install new hardware and virtual tools to communicate with their management and teammates, and complete assigned tasks. These changes transformed dynamics inside the team and between employees and management (Alexander et al., 2020; Ambrogio et al., 2022).
Today, in the new working world of work-life balance "competition," work has a notable victory. When physical separation of office and home no longer exists, people fail to keep an equilibrium between their work and private life, creating a significant work-life conflict (WLC) (Boswell et al., 2007; Vaziri et al., 2020). Fast-progressing technology allowed continuous remote access, creating the organizational expectation for employees' constant availability, resulting in long work hours, burnout, and stress (Adisa et al., 202
Optimizing Performance Through Leadership Decision-Making
No full textPressures to remain agile and flexible while struggling with costly operations and sustaining competitiveness in the global market have forced leadership to make complex, organizational decisions quickly. This study explores best practices in decision-making for senior leaders to improve organizational performance by re-engaging middle management in strategic decisions. Ludwig Von Bertalanffy general system theory and Herbert Simon’s decision-making theory guide the research. Combined, this theoretical framework views the organization as an entire system and effective decision-making as an integrated subsystem. Themes. Findings revealed five emerging themes: (1) Leadership styles influence decision making; (2) relevant information is necessary to make rational, quality decisions; (3) advantages and disadvantages exist for engaging middle managers in senior executive decision making; (4) adopted best practices lead to effective decision making and improved organizational performance; and, (5) internal and external factors impact organizational decisions and how they are made. Recommendations: Three recommendations are presented: Perform an assessment of individual leadership styles; create a standard decision-making process; and engage middle managers in senior leadership decision-making. Implications: A concept called middle management optimization is introduced to management practice to help leaders optimize the support that middle managers can provide in leadership decisions to improve organizational performance.Abstract
Title of Dissertation: Optimizing Performance Through Leadership Decision-Making
Naomi DeShields Sims, DBA, 2022
Pressures to remain agile and flexible while struggling with costly operations and sustaining competitiveness in the global market have forced leadership to make complex, organizational decisions quickly. This study explores best practices in decision-making for senior leaders to improve organizational performance by re-engaging middle management in strategic decisions. Ludwig Von Bertalanffy general system theory and Herbert Simon’s decision-making theory guide the research. Combined, this theoretical framework views the organization as an entire system and effective decision-making as an integrated subsystem. Themes. Findings revealed five emerging themes: (1) Leadership styles influence decision making; (2) relevant information is necessary to make rational, quality decisions; (3) advantages and disadvantages exist for engaging middle managers in senior executive decision making; (4) adopted best practices lead to effective decision making and improved organizational performance; and, (5) internal and external factors impact organizational decisions and how they are made. Recommendations: Three recommendations are presented: Perform an assessment of individual leadership styles; create a standard decision-making process; and engage middle managers in senior leadership decision-making. Implications: A concept called middle management optimization is introduced to management practice to help leaders optimize the support that middle managers can provide in leadership decisions to improve organizational performance.
Keywords: decision-making, senior leadership, re-engagement, middle managers, organizational performance.
Optimizing Performance Through Leadership Decision-Making
by
Naomi DeShields Sims
Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Business Administration
University of Maryland Global Campus
September 2022
iv
Dedication
This dissertation is first dedicated to my mother whose dying wish was to ensure her little children were well taken care of and received a good education. Mom, this is my highest honor in memory of you! Second, to my father who told me that I could achieve anything I aspired to do. Third, to my siblings who are my true heroes in life. Finally, to my three amazing sons, my lions who are my greatest accomplishments, pride, and joy. To God be the Glory. To my family and friends, thanks for all your encouragement and many sacrifices. To all who read this dissertation, never stop learning and believing in yourself.
v
Acknowledgments
I would like to acknowledge and honor exceptional contributors to this dissertation. First, Dr. Laura Witz, my primary academic mentor. You are absolutely amazing! I could not have achieved this goal without your tough but incredibly wise feedback and guidance, constant encouragement, patience, and push for me to think and become a true scholar. Dr. Raymond Marbury, my second academic mentor. You have a gift of helping others look at a management problem through a theoretical lens and turn it into a topic worthy of scholarly research. Thanks for challenging me along the way.
I would also like to acknowledge the cohort members that I had the privilege of learning and collaborating with throughout the doctorate program and dissertation journey. We shared and learned so much from each other. Thanks for grabbing my hand whenever I wanted to pull back! I could not have completed this goal without your empathy and encouragement, and I hope I did the same for you. Next, I would like to acknowledge Andra Hoxie who told me to never give up on my dream and keep the faith, Dr. Rich Hornberger, Dr. Joanna Bennerson, and Dr. Barthelus, who took the time to offer guidance and shared their experiences. Thank you, to all those who made sacrifices for me as I furthered my educational pursuit.
vi
Table of Contents
List of Tables ............................................................................................................................................... iv
List of Figures ............................................................................................................................................... v
Chapter 1: Introduction and Overview of the Management Problem ......................................................... 1
Overview of Management Problem ......................................................................................................... 1
The Value of Effective Communication .................................................................................................... 3
Perception of Middle Managers ............................................................................................................... 4
Purpose of Study ..................................................................................................................................... 5
Undervaluing Middle Managers ......................................................................................................... 6
Returning to Middle Managers .......................................................................................................... 8
Organization of the Study ......................................................................................................................... 8
Chapter 2: Scoping Literature Review and Theoretical Framework ........................................................... 11
Decision-Making ............................................................................................................................... 11
Calculated Choice ............................................................................................................................. 12
A Strategic Process ........................................................................................................................... 13
Decision Errors ................................................................................................................................ 14
Misjudging Risks and Business Models ............................................................................................ 15
Deciding Under Stress ...................................................................................................................... 16
Minimizing Decision Errors Through Inclusion ................................................................................. 17
Leadership Styles .............................................................................................................................. 18
vii
Organizational Performance ............................................................................................................ 19
Leadership’s Responsibility for Performance................................................................................... 20
Challenges ....................................................................................................................................... 20
Middle Managers ............................................................................................................................. 21
Middle Management Roles .............................................................................................................. 21
Re-Introducing Senior Leadership to Middle Managers .................................................................. 22
Known Contributions to Organizational Performance ..................................................................... 22
Ability to Fulfill the Requirements of Sound Decision-Making ........................................................ 23
Active Elimination of this Resource ................................................................................................. 24
Passive Failure to Harness this Resource ......................................................................................... 24
Disengagement ............................................................................................................................... 25
Costs to Middle Management Attitudes and Performance ............................................................. 26
Cost of Organizational Performance ................................................................................................ 27
Harnessing the Capabilities of Middle Managers ............................................................................ 27
Re-Engagement ............................................................................................................................... 27
Benefits of Re-Engagement .............................................................................................................. 28
Theoretical Framework .......................................................................................................................... 30
General System Theory- A View of the Organization as a Whole ...................................................... 30
Decision-Making Theory- Bounded Rationality as the Primary Ingredient for Decision-Making ...... 33
Applying the Theory to Senior Leadership Decision-Making ............................................................. 34
Combining the Theories ..................................................................................................................... 36
Chapter Summary .............................................................................................................................. 37
viii
Chapter 3: The Methodology ...................................................................................................................... 39
Review Design and Methodology ........................................................................................................... 39
The Evidence-Based Research Framework ............................................................................................. 40
The Systematic Review Described .......................................................................................................... 41
Types of Systematic Reviews .................................................................................................................. 43
Stakeholders and Subject Matter Experts .............................................................................................. 45
Systematic Review- A Realist Synthesis Process .................................................................................... 45
Search Strategy ...................................................................................................................................... 46
Search Locations .................................................................................................................................... 47
Search Terms ......................................................................................................................................... 47
Searching Using the Boolean Logic Approach ........................................................................................ 48
Inclusion and Exclusion Criteria .............................................................................................................. 51
Inclusion Methodology of Selecting Date Ranges ............................................................................. 51
Types of Sources Included ................................................................................................................. 52
Sources for Searching Evidence .............................................................................................................. 53
Grey Literature .................................................................................................................................. 53
Hard Searching .................................................................................................................................. 53
Peer-Reviewed Publications .............................................................................................................. 53
Other Inclusion and Exclusion Criteria ................................................................................................... 54
Inclusion Criteria ............................................................................................................................... 55
Exclusion Criteria............................................................................................................................... 55
ix
Selective Screening .......................................................................................................................... 55
Organization of Data Collection and Ranking ......................................................................................... 56
PRISMA Diagram .................................................................................................................................... 56
Method of Quality Appraisal of the Included Studies ............................................................................ 59
Weight of Evidence A (Reliability) .......................................................................................................... 60
Weight of Evidence B (Relevance) ......................................................................................................... 60
Weight of Evidence C (Consistency) ...................................................................................................... 60
Analysis and Synthesis Methodology ...................................................................................................... 62
Coding as an Iterative Process ................................................................................................................. 64
Open Coding .......................................................................................................................................... 66
Axial and Selective Coding ...................................................................................................................... 66
Selective Coding .................................................................................................................................... 66
Thematic Analysis .................................................................................................................................. 67
Chapter Summary .................................................................................................................................. 68
Chapter 4: Analysis and Findings ................................................................................................................ 69
Subject Matter Experts ........................................................................................................................... 69
Recruitment of SMEs .............................................................................................................................. 69
Summary of SME Feedback .................................................................................................................... 70
Theoretical Framework and General Feedback ..................................................................................... 71
Results of Source Search ........................................................................................................................ 73
Boolean T1 Search Results...................................................................................................................... 74
x
Boolean T2 Search Results...................................................................................................................... 75
Boolean T3 Search Results...................................................................................................................... 76
Summary of Final Source Pool ................................................................................................................ 76
Results of Relevancy Screening .............................................................................................................. 77
Results of the Quality Appraisal of the Data Set .................................................................................... 80
Summary of WoE Scores ........................................................................................................................ 81
Characteristics of Sources ...................................................................................................................... 81
Data Range Selection .............................................................................................................................. 86
Open Coding .......................................................................................................................................... 86
Second Cycle-Axial Coding ....................................................................................................................... 88
Third Cycle Selective Coding ................................................................................................................... 90
Finding Discussion-Realist Synthesis Approach ...................................................................................... 91
1. Leadership Characteristics and Styles .......................................................................................... 91
2. Availability of Quality of Information ........................................................................................... 92
3. Pros & Cons of Engaging Middle Management ............................................................................ 92
4. Best Practices in Senior Leadership Decision-Making .................................................................. 92
5. Impact of Contingent Factors on Organization-Wide Decisions .................................................. 92
Finding 1- Characteristics and Styles ...................................................................................................... 96
Leadership Style Influences ............................................................................................................... 97
Leadership Support of Middle Management Engagement................................................................ 97
Top Managers Verses Middle Management Perceptions .................................................................. 97
Finding 2-Availability of Quality Information ......................................................................................... 98
xi
Need for Quality, Accurate Information to Make Informed Decisions .............................................. 99
Information Gathering Through Engagement and Participation .................................................... 100
Variables that Impact the Use of Quality and Accurate Information .............................................. 100
Finding 3- Pros and Cons of Engaging Middle Management ............................................................... 101
Pros of Engaging Middle Managers Senior Leadership Decision-Making ........................................ 102
Benefits of Middle Management Engagement ................................................................................ 103
Cons of Engaging Middle Managers in Senior Leadership Decision Making ................................... 104
Finding 4-Best Practices in Senior Leadership Decision-Making .......................................................... 104
Decision-Making Starts with a Strong Foundation and Standards .................................................. 105
Senior Leadership Decision-Making Models and Processes ............................................................ 106
Finding 5- Internal and External Conditions Have a Direct Link to Decision-Making Practices and
Performance Outcomes ................................................................................................................... 107
External and Internal Environmental Factors That Impact Organizational Outcomes ......
Machine learning methods to detect Medicare fraud and abuse in US healthcare
No full textMedical fraud is a severe problem that is worsening, with grave repercussions for the healthcare
industry and an annual cost to the government of 54 billion due to fraud, errors, and abuse. Medicare, the largest public health insurance program in the United States, has been the primary target of healthcare fraud. This study explored machine learning (ML) methods for Medicare fraud detection and answered the research question: “Can machine learning methods detect Medicare fraud and abuse in U.S. healthcare?” “If so, how?” The study relied on the Fraud Triangle Theory as the theoretical framework to view the problem. A systematic review was utilized to execute the study and relied on the findings from 39 studies. The study provided four recommendations for practitioners: (1) Government needs to build machine learning models for healthcare providers for fraud detection. (2) More research and improved machine learning methods should be used to detect the many abnormalities in health insurance fraud. (3) Government should introduce a variety of machine learning methods to utilize digital data for fraud prevention in the healthcare industry. (4) Healthcare systems should implement machine learning techniques for financial fraud detection.
Keywords: Machine learning, unsupervised and supervised learning, Medicare fraud and abuse, fraud detection MACHINE LEARNING METHODS TO DETECT MEDICARE FRAUD AND ABUSE IN US HEALTHCARE
iii
© Copyright by
Ally Simbert
2023
MACHINE LEARNING METHODS TO DETECT MEDICARE FRAUD AND ABUSE IN US HEALTHCARE
iv
Dedication
This work is dedicated to my son Tristan, my daughter Emily, my wife Pamela, and my parents, who gave me endless love, support, and encouragement. Their unwavering support has always been reliable. You have made me stronger, better, and happier than I could have ever imagined. I also dedicate this work to all my friends, who constantly remind me that I can do it. MACHINE LEARNING METHODS TO DETECT MEDICARE FRAUD AND ABUSE IN US HEALTHCARE
v
Acknowledgments
I would like to express my heartfelt appreciation to Dr. James Gelatt, my research supervisor, for providing invaluable guidance throughout this study. His energy, vision, sincerity, and drive profoundly inspired me. He has instructed me on how to conduct research and present it in the most concise manner possible. Working and studying under his supervision was a privilege and an honor. I am incredibly appreciative of what he has given me. I would also like to thank him for his friendship, compassion, and witty disposition.
I am incredibly appreciative of my family's love, prayers, care, and sacrifices for educating and preparing me for the future. I am extremely grateful to my wife, my son, and my daughters for their love, understanding, prayers, and unwavering support throughout the completion of this research project.
Finally, I would like to thank everyone who helped me complete the research, whether directly or indirectly.
MACHINE LEARNING METHODS TO DETECT MEDICARE FRAUD AND ABUSE IN US HEALTHCARE
vi
Table of Contents
MACHINE LEARNING METHODS TO DETECT MEDICARE FRAUD AND ABUSE IN US HEALTHCARE .......................................................................................................................... i
Abstract .................................................................................................................................... ii
Dedication ................................................................................................................................ iv
Acknowledgments .......................................................................................................................v
Table of Contents ...................................................................................................................... vi
List of Tables ............................................................................................................................ ix
List of Figures .............................................................................................................................x
Chapter 1: Introduction and Overview of the Management Problem ............................................1
Background and Overview ......................................................................................................1
Issues with Manual ProcessingIssues with Manual ProcessingIssues with Manual ProcessingIssues with Manual Processing Issues with Manual ProcessingIssues with Manual ProcessingIssues with Manual ProcessingIssues with Manual Processing Issues with Manual Processing Issues with Manual ProcessingIssues with Manual Processing Issues with Manual ProcessingIssues with Manual ProcessingIssues with Manual Processing Issues with Manual ProcessingIssues with Manual ProcessingIssues with Manual ProcessingIssues with Manual Processing ................................ ................................ ............................ 1
Doctor Doctor -Patient TrustPatient Trust Patient TrustPatient Trust Patient TrustPatient TrustPatient Trust Patient Trust ................................ ................................ ................................ ............ 2
Healthcare CostHealthcare CostHealthcare Cost Healthcare Cost Healthcare CostHealthcare CostHealthcare CostHealthcare Cost Healthcare Cost ................................ ................................ ................................ ................... 2
Healthcare Fraud Healthcare Fraud Healthcare Fraud Healthcare Fraud Healthcare FraudHealthcare FraudHealthcare FraudHealthcare FraudHealthcare Fraud ................................ ................................ ................................ ................. 4
Understanding Machine Learning Understanding Machine LearningUnderstanding Machine LearningUnderstanding Machine Learning Understanding Machine Learning Understanding Machine LearningUnderstanding Machine Learning Understanding Machine Learning Understanding Machine LearningUnderstanding Machine LearningUnderstanding Machine Learning Understanding Machine Learning ................................ ................................ ........................ 4
Benefits of Machine Learning (ML) tBenefits of Machine Learning (ML) tBenefits of Machine Learning (ML) t Benefits of Machine Learning (ML) t Benefits of Machine Learning (ML) t Benefits of Machine Learning (ML) tBenefits of Machine Learning (ML) t Benefits of Machine Learning (ML) tBenefits of Machine Learning (ML) t Benefits of Machine Learning (ML) t Benefits of Machine Learning (ML) tBenefits of Machine Learning (ML) tBenefits of Machine Learning (ML) tBenefits of Machine Learning (ML) t Benefits of Machine Learning (ML) t Benefits of Machine Learning (ML) tBenefits of Machine Learning (ML) tBenefits of Machine Learning (ML) tBenefits of Machine Learning (ML) tBenefits of Machine Learning (ML) tBenefits of Machine Learning (ML) tools ................................ ................................ ............. 5
How Machine Learning (ML) works How Machine Learning (ML) worksHow Machine Learning (ML) worksHow Machine Learning (ML) works How Machine Learning (ML) works How Machine Learning (ML) worksHow Machine Learning (ML) worksHow Machine Learning (ML) works How Machine Learning (ML) works How Machine Learning (ML) worksHow Machine Learning (ML) worksHow Machine Learning (ML) worksHow Machine Learning (ML) worksHow Machine Learning (ML) worksHow Machine Learning (ML) worksHow Machine Learning (ML) works How Machine Learning (ML) worksHow Machine Learning (ML) works ................................ ................................ ..................... 5
Understanding Medicare FraudUnderstanding Medicare Fraud Understanding Medicare FraudUnderstanding Medicare FraudUnderstanding Medicare Fraud Understanding Medicare FraudUnderstanding Medicare FraudUnderstanding Medicare Fraud Understanding Medicare Fraud Understanding Medicare FraudUnderstanding Medicare FraudUnderstanding Medicare FraudUnderstanding Medicare FraudUnderstanding Medicare Fraud ................................ ................................ ........................... 6
Medicare Fraud and Abuse LawsMedicare Fraud and Abuse LawsMedicare Fraud and Abuse Laws Medicare Fraud and Abuse LawsMedicare Fraud and Abuse LawsMedicare Fraud and Abuse LawsMedicare Fraud and Abuse LawsMedicare Fraud and Abuse Laws Medicare Fraud and Abuse Laws Medicare Fraud and Abuse LawsMedicare Fraud and Abuse Laws Medicare Fraud and Abuse LawsMedicare Fraud and Abuse LawsMedicare Fraud and Abuse LawsMedicare Fraud and Abuse Laws Medicare Fraud and Abuse Laws ................................ ................................ ......................... 6
Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) ................................ ................................ ................ 7
False Claims Act (FCA)False Claims Act (FCA) False Claims Act (FCA)False Claims Act (FCA)False Claims Act (FCA)False Claims Act (FCA) False Claims Act (FCA) False Claims Act (FCA)False Claims Act (FCA)False Claims Act (FCA)False Claims Act (FCA) False Claims Act (FCA)False Claims Act (FCA)False Claims Act (FCA)False Claims Act (FCA)False Claims Act (FCA) ................................ ................................ ................................ ....... 7
AntiAnti -Kickback Statute (AKS)Kickback Statute (AKS) Kickback Statute (AKS) Kickback Statute (AKS)Kickback Statute (AKS)Kickback Statute (AKS) Kickback Statute (AKS) Kickback Statute (AKS)Kickback Statute (AKS)Kickback Statute (AKS)Kickback Statute (AKS) ................................ ................................ ................................ 8
Physician SelfPhysician Self Physician SelfPhysician Self Physician Self Physician Self -Referral Law (Stark Law)Referral Law (Stark Law)Referral Law (Stark Law) Referral Law (Stark Law)Referral Law (Stark Law) Referral Law (Stark Law)Referral Law (Stark Law) Referral Law (Stark Law)Referral Law (Stark Law)Referral Law (Stark Law) Referral Law (Stark Law)Referral Law (Stark Law)Referral Law (Stark Law)Referral Law (Stark Law) Referral Law (Stark Law) ................................ ................................ .............. 9
Exclusion StatuteExclusion StatuteExclusion StatuteExclusion Statute Exclusion Statute Exclusion Statute ................................ ................................ ................................ .................. 9
Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL)Civil Monetary Penalties Law (CMPL) ................................ ................................ ................ 9
Problem Statement and Significance of the Problem .............................................................. 10
Purpose of the Study and The Research Question .................................................................. 12
EvidenceEvidenceEvidence Evidence-Based ManagementBased Management Based ManagementBased Management Based ManagementBased Management Based Management Based ManagementBased Management Based Management ................................ ................................ ............................. 12
The Research Question The Research QuestionThe Research QuestionThe Research QuestionThe Research QuestionThe Research Question The Research QuestionThe Research Question The Research QuestionThe Research Question The Research QuestionThe Research Question ................................ ................................ ................................ ...... 13
Rationale for the Study or Significance of the Study .............................................................. 14
Fraud Triangle TheoryFraud Triangle TheoryFraud Triangle Theory Fraud Triangle Theory Fraud Triangle TheoryFraud Triangle TheoryFraud Triangle Theory Fraud Triangle Theory Fraud Triangle TheoryFraud Triangle TheoryFraud Triangle TheoryFraud Triangle Theory Fraud Triangle Theory ................................ ................................ ................................ ..... 15
Definitions and Terminology ................................................................................................. 16
Chapter Summary .................................................................................................................. 19
Organization of the Dissertation ............................................................................................ 19
Chapter 2: Scoping Literature Review and Theoretical Frame ................................................... 21
Theoretical Framework .......................................................................................................... 21
The Literature Landscape or Scoping Literature Review ........................................................ 23
Demographics Demographics Demographics ................................ ................................ ................................ .................... 24
The Cost of Healthcare The Cost of HealthcareThe Cost of Healthcare The Cost of Healthcare The Cost of Healthcare The Cost of HealthcareThe Cost of HealthcareThe Cost of Healthcare The Cost of Healthcare The Cost of Healthcare ................................ ................................ ................................ ...... 24
What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)? What is Artificial Intelligence (AI)? What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)? What is Artificial Intelligence (AI)? What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)? What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)? What is Artificial Intelligence (AI)? What is Artificial Intelligence (AI)? What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)?What is Artificial Intelligence (AI)? ................................ ................................ .................... 24 MACHINE LEARNING METHODS TO DETECT MEDICARE FRAUD AND ABUSE IN US HEALTHCARE
vii
Traditional Methods of Fraud DetectionTraditional Methods of Fraud DetectionTraditional Methods of Fraud Detection Traditional Methods of Fraud Detection Traditional Methods of Fraud DetectionTraditional Methods of Fraud DetectionTraditional Methods of Fraud DetectionTraditional Methods of Fraud Detection Traditional Methods of Fraud DetectionTraditional Methods of Fraud Detection Traditional Methods of Fraud DetectionTraditional Methods of Fraud DetectionTraditional Methods of Fraud DetectionTraditional Methods of Fraud Detection Traditional Methods of Fraud Detection Traditional Methods of Fraud Detection Traditional Methods of Fraud Detection Traditional Methods of Fraud Detection ................................ ................................ ............ 25
Fraud ManagementFraud ManagementFraud Management Fraud ManagementFraud Management Fraud ManagementFraud ManagementFraud ManagementFraud Management ................................ ................................ ................................ ............ 28
Examples of success in fraud detectionExamples of success in fraud detectionExamples of success in fraud detection Examples of success in fraud detection Examples of success in fraud detectionExamples of success in fraud detectionExamples of success in fraud detection Examples of success in fraud detectionExamples of success in fraud detection Examples of success in fraud detectionExamples of success in fraud detectionExamples of success in fraud detectionExamples of success in fraud detectionExamples of success in fraud detectionExamples of success in fraud detection Examples of success in fraud detection Examples of success in fraud detection Examples of success in fraud detection Examples of success in fraud detection Examples of success in fraud detectionExamples of success in fraud detection ................................ ................................ ............... 27
Conceptual Framework .......................................................................................................... 28
Chapter Summary .................................................................................................................. 30
Chapter 3: Method .................................................................................................................... 32
Review Design and Methodology .......................................................................................... 32
The EvidenceThe Evidence The EvidenceThe EvidenceThe EvidenceThe Evidence The Evidence-Based Research FrameworkBased Research Framework Based Research FrameworkBased Research Framework Based Research FrameworkBased Research FrameworkBased Research FrameworkBased Research FrameworkBased Research Framework Based Research FrameworkBased Research Framework Based Research FrameworkBased Research FrameworkBased Research Framework Based Research FrameworkBased Research Framework Based Research Framework ................................ ................................ ......... 32
EvidenceEvidenceEvidence Evidence-Based ManagementBased Management Based ManagementBased Management Based ManagementBased Management Based Management Based ManagementBased Management Based Management ................................ ................................ ............................. 33
Systematic Reviews Systematic ReviewsSystematic Reviews Systematic Reviews Systematic ReviewsSystematic ReviewsSystematic ReviewsSystematic ReviewsSystematic ReviewsSystematic Reviews Systematic Reviews ................................ ................................ ................................ ............ 34
Systematic Review Process Systematic Review ProcessSystematic Review Process Systematic Review Process Systematic Review ProcessSystematic Review ProcessSystematic Review ProcessSystematic Review ProcessSystematic Review ProcessSystematic Review Process Systematic Review ProcessSystematic Review ProcessSystematic Review ProcessSystematic Review Process Systematic Review ProcessSystematic Review ProcessSystematic Review Process ................................ ................................ ................................ . 35
Search Strategy Search Strategy Search StrategySearch Strategy Search Strategy Search Strategy ................................ ................................ ................................ .................. 36
Method of Quality Appraisal the Included StudiesMethod of Q
Improving financial and quality outcomes: Competencies of successful hospital CEOs
No full textHealth care in the United States is the most expensive in the developed countries and is one
of the lowest rated in terms of quality outcomes. Though the national numbers are
disturbing, healthcare is delivered locally making performance and quality of the local
hospital critical. The problem statement is that CEOs may not have the right competencies
and traits to improve hospital performance. The purpose of the study was to discover what
hospital CEO competencies impact financial and quality outcomes. The research question
focused on hospitals and CEO driven outcomes measured by net income (NI), return on
assets (ROA) and Hospital Consumer Assessment of Healthcare Providers and System
(HCAHPS) scores. The conceptual framework was developed based on Competency,
Complex Adaptive Systems, and Systems theories. Data was collected using three
healthcare databases and a search string including components from the research question.
Analysis of findings used four cycle coding. Four themes were elucidated: (1) CEOs matter
and they impact ROA, and NI; (2) CEOs impact outcomes related to quality and patient
satisfaction; (3) models exist detailing needed CEO competencies that are generally
consistently focused on education and similar to findings from this study; and (4) there is
causality linking certain competencies to certain outcomes.i
Abstract
Title of Dissertation: IMPROVING FINANCIAL AND QUALITY OUTCOMES:
COMPETENCIES OF SUCCESSFUL HOSPITAL CEOs
Bonnie Phipps,
Doctor of Business Administration, 2022
Health care in the United States is the most expensive in the developed countries and is one
of the lowest rated in terms of quality outcomes. Though the national numbers are
disturbing, healthcare is delivered locally making performance and quality of the local
hospital critical. The problem statement is that CEOs may not have the right competencies
and traits to improve hospital performance. The purpose of the study was to discover what
hospital CEO competencies impact financial and quality outcomes. The research question
focused on hospitals and CEO driven outcomes measured by net income (NI), return on
assets (ROA) and Hospital Consumer Assessment of Healthcare Providers and System
(HCAHPS) scores. The conceptual framework was developed based on Competency,
Complex Adaptive Systems, and Systems theories. Data was collected using three
healthcare databases and a search string including components from the research question.
Analysis of findings used four cycle coding. Four themes were elucidated: (1) CEOs matter
and they impact ROA, and NI; (2) CEOs impact outcomes related to quality and patient
satisfaction; (3) models exist detailing needed CEO competencies that are generally
consistently focused on education and similar to findings from this study; and (4) there is
causality linking certain competencies to certain outcomes.
Keywords: Hospital, CEO, competencies, complexity, financial outcomes, quality
outcomes
ii
IMPROVING FINANCIAL AND QUALITY OUTCOMES: COMPETENCIES
OF SUCCESSFUL HOSPITAL CEOs
By
Bonnie Phipps
Dissertation submitted to the School of Business,
University of Maryland Global Campus, in partial fulfillment
of the requirements for the degree of
Doctor of Business Administration
2022
iii
© Copyright by
Bonnie Phipps
2022
iv
Acknowledgements
After a three-year journey, it is impossible to acknowledge all of the people who
have molded me and this dissertation. Most important is the support from Dr. Raymond
Marbury who is a great cheerleader and Dr. Laura Witz who keeps us all focused and
attentive to detail while throwing in a “great job” along the way. Dr. Kathleen (Kay)
Edwards also sent encouragement and some pertinent articles along the way.
Our cohort bonded early and had weekly calls to support each other so thanks to
Gilbert, Starlyn, Cyrus, and Liz. I should also thank my editor, Dr, Michael Poock, for his
support. And, of course, my husband and family who left me alone in my clutter!
v
Table of Contents
Abstract .................................................................................................................................. i
IMPROVING FINANCIAL AND QUALITY OUTCOMES: COMPETENCIES OF
SUCCESSFUL HOSPITAL CEOs ........................................................................................ ii
Copyright ............................................................................................................................... iii
Acknowledgements ............................................................................................................... iv
Table of Contents ................................................................................................................... v
List of Tables .......................................................................................................................... x
List of Figures ....................................................................................................................... xi
List of Abbreviations ............................................................................................................ xii
Chapter 1: Introduction and Overview of the Management Problem .................................... 1
Government Efforts in Quality Improvements ....................................................................... 3
Financial Implications ............................................................................................................ 4
Finding the right CEO ............................................................................................................ 5
Problem Statement and Significance of the Problem ............................................................ 6
Leaders ............................................................................................................................... 7
Purpose of the Study & Research Question ....................................................................... 8
Rationale for the Study and Significance ........................................................................... 9
Discussion of Assumptions and Themes ......................................................................... 10
Definitions and Terminology ........................................................................................... 11
Organization of the Dissertation ........................................................................................... 12
Chapter Summary ................................................................................................................. 12
Chapter 2: Scoping Literature Review and Theoretical Frame ............................................ 14
Introduction .......................................................................................................................... 14
vi
The CEO and Organizational Performance…………………………………………………14
Gender .............................................................................................................................. 15
Age and Tenure ................................................................................................................ 15
Education and Training .................................................................................................... 15
Physician versus Business Manager CEOs ...................................................................... 16
Impact of Complexity ...................................................................................................... 16
External Environment ........................................................................................................... 17
Internal Environment ............................................................................................................ 17
Theoretical Framework ........................................................................................................ 17
Competency Theory ......................................................................................................... 18
General Systems Theory .................................................................................................. 18
Complex Adaptive Systems Theory ................................................................................ 20
Conceptual Framework .................................................................................................... 21
Chapter Summary ................................................................................................................. 23
Chapter 3: Methodology ....................................................................................................... 24
Review of Design and Methodology .................................................................................... 24
Methodology .................................................................................................................... 24
Research Approach ........................................................................................................... 25
Design ............................................................................................................................... 26
Systematical Reviews ....................................................................................................... 26
Appropriateness of a Systematic Review ......................................................................... 27
The Evidence-Based Research Framework .......................................................................... 30
Evidence-Based Management .......................................................................................... 30
vii
Evidence-based Research ................................................................................................. 31
Evidence-based Decision Making .................................................................................... 32
Systematic Review Process .............................................................................................. 32
Protocol and Structure ...................................................................................................... 33
Subject Matter Experts ..................................................................................................... 35
Search Strategy ................................................................................................................ 38
Search String .................................................................................................................... 39
Pre-Set Inclusion/Exclusion Limiters .............................................................................. 40
Results of Database Search .................................................................................................. 41
Snowballing ..................................................................................................................... 43
Coding This Study ........................................................................................................... 44
Quality Appraisal ............................................................................................................. 46
Method of Analysis and Synthesis ................................................................................... 50
Realistic and Thematic Synthesis .................................................................................... 51
Development of Themes .................................................................................................. 53
Publication Bias ............................................................................................................... 54
Other Bias ........................................................................................................................ 54
Chapter Summary ................................................................................................................. 55
Chapter 4: Analysis and Findings ........................................................................................ 57
Review of Research Question and Literature Search ........................................................... 57
Research Question ........................................................................................................... 57
Literature Search .............................................................................................................. 57
Description of the Sources ............................................................................................... 58
viii
Results of the Quality Appraisal of the Source Set .......................................................... 60
Analysis of the Source Set ............................................................................................... 61
Findings and Discussion ....................................................................................................... 65
Finding 1 ............................................................................................................................... 65
Quantitative Evidence ...................................................................................................... 65
Qualitative Evidence ........................................................................................................ 68
Rating Agencies ............................................................................................................... 69
Finding 2 ............................................................................................................................... 69
Finding 3 ............................................................................................................................... 72
Competency Models ........................................................................................................ 73
Pros and Cons of Competency Models ............................................................................ 74
Competencies During Crisis ............................................................................................ 76
Finding 4 ............................................................................................................................... 77
Review of the Findings ......................................................................................................... 78
Conceptual Framework ........................................................................................................ 80
Chapter Summary ................................................................................................................. 81
Chapter 5: Conclusion and Implications .............................................................................. 83
Review of the Research ........................................................................................................ 83
Answering the Research Question ........................................................................................ 84
Management Implications and Recommendations ............................................................... 87
Business Implications and Knowledge Sharing ............................................................... 93
Bias and Limitations ............................................................................................................. 94
Consider the Effects of Bias ............................................................................................ 94
ix
Limitations ....................................................................................................................... 95
Recommendations for Future Research ................................................................................ 96
Final Summary and Conclusion ........................................................................................... 98
References ...........................................................................................................................101
Appendix A UMGC OneSearch Databases .........................................................................120
Appendix B Excel Article Review Chart ............................................................................122
Appendix C TAPUPAS Chart .............................................................................................135
Appendix D Weight of Evidence Chart ...............................................................................137
Appendix E Consolidated Quality Results ..........................................................................139
Appendix F Level 1 Coding (36) ........................................................................................140
Appendix G Level 2 Coding (99) ........................................................................................142
Appendix H Level 3 Coding (86) ........................................................................................145
Appendix I Level 4 Coding (76) .........................................................................................148
Appendix J Analysis of Evidence Findings ........................................................................150
Appendix K Comparison to Non-hospital Competencies ...................................................152
Appendix L Comparison of Existing Models ......................................................................153
Appendix M Causal Findings ..............................................................................................156
Appendix N Sample Competency Interview Questions ......................................................157
x
List of Tables
Table 1 When to do a Systematic Review ..............................................................................28
Table 2 Subject Matter Expert Panel ......................................................................................37
Table 3 Keywords for Search String .......................................................................................39
Table 4 TAPUPAS and Weight of Evidence Framework ......................................................49
Table 5 Quality Appraisal Tool Scoring .................................................................................50
Table 6 Examples of Evidence Synthesis ...............................................................................51
Table 7 Data Set Description ..................................................................................................59
Table 8 Dates of Included Articles .........................................................................................60
Table 9 Themes .......................................................................................................................64
Table 10 CEO Impact on ROA ...............................................................................................67
Table 11 Quality and Financial Outcomes ..............................................................................70
Table 12 Summary of Research Findings ...............................................................................72
Table 13 Pros and Cons of Competency Models ....................................................................75
Table 14 Competency and Outcome Causality .......................................................................77
Table 15 Example of Hospital Profile ....................................................................................89
xi
List of Figures
Figure 1 Conceptual Framework ...........................................................................................21
Figure 2 Evidence Pyramid ...................................................................................................27
Figure 3 Systematic Review Protocol ...................................................................................34
Figure 4 PRISMA Chart ........................................................................................................43
Figure 5 Word Cloud .............................................................................................................63
Figure 6 Impact of the Leader on Outcomes .........................................................................70
Figure 7 Bi-directional Relationship .....................................................................................81
Figure 8 Return on Competencies in a Complex Adaptive System ......................................87
xii
List of Abbreviations
ACA – Affordable Care Act
ACHE – American College of Healthcare Executives
AHA – American Hospital Association
AMC – Academic Medical Center
CAS – Complex Adaptive Systems
CMMI – Center for Medicare and Medicaid Innovation
CMS – Center for Medicare and Medicaid Services
COVID – Corona Virus Disease
EBDM – Evidence-based Decision Making
EBMgmt – Evidence-based Management
EBR – Evidence-based Research
FREOPP – Foundation for Research for Equal Opportunity
GNP – Gross Domestic Product
HCAHPS – Hospital Consumer Assessment of Healthcare Providers and Services
HFMA – Healthcare Financial Management Association
HRRP – Hospital Readmission Reduction Program
NI – Net Income
ROA – Return on Assets
ROC – Return on Competence
ROQ – Return on Quality
SARS – Severe Acute Respiratory Syndrome
SDoH – Social Determinants of Health
SME – Subject Matter Expert
VPB – Value Based Purchasing
WoE – Weight of Evidence
1
Chapter 1: Introduction and Overview of the Management Problem
It is important to understand the significance of the healthcare system in the United
States to appreciate the magnitude of the issues and impact that is seen nationally and
locally. This Chapter introduces different aspects of the sector first lookin
Fracturing the ceiling: Exploring the organizational factors in the advancement of women of color to senior leadership in U.S. organizations
No full textWomen of color have distinct racial and ethnic experiences in all sectors and industries, but their
absence in senior leadership roles in the United States is notable. Women of color continue to be
underrepresented in senior leadership positions despite their ambition to advance and top
executives’ intention to achieve diversity in the executive suite. A systematic review examined
the factors that affect women of color on the path to senior leadership roles by analyzing and
synthesizing a dataset of 32 articles and by applying a theoretical framework of intersectionality
theory, institutional theory of diversity management, and resource-based theory of diversity
management. While this study’s findings show that effective diversity management practices are
linked to an increase in the number of women in senior leadership roles, it also showed that
women of color were disadvantaged in times of organizational crisis when access to senior
leadership afforded neither support nor tools to succeed. The data also found that women of color
in senior leadership roles had shorter tenure due to the scrutiny of their leadership, while those
who were supported by mentors and sponsors tended to be more successful. Women of color
relied on their own ingenuity to devise advancement strategies that allowed them to penetrate
institutional networks previously closed to them. It is recommended that managers assess the
efficacy of existing and planned diversity management practices to find ways to maintain
corporate support for women of color aspiring to senior leadership, recognizing that this is a
critical component in increasing diversity amongst executives. One such practice is the creation
of pipeline programs that enable women of color to advance from middle to senior management
positions. Programs that train and promote women of color can also provide mentoring and
networking support for women of color committed to obtaining senior leadership positions.
Finally, among those who support executive diversity programs and diversity initiatives, it is
important to extend awareness on what is the road to success for women of color desiring senior
leadership roles.Abstract
Title of the Dissertation: FRACTURING THE CEILING: EXPLORING
THE ORGANIZATIONAL FACTORS IN THE
ADVANCEMENT OF WOMEN OF COLOR TO
SENIOR LEADERSHIP IN U.S.
ORGANIZATIONS
Sharron Graves
Doctor of Business Administration, 2021
Women of color have distinct racial and ethnic experiences in all sectors and industries, but their
absence in senior leadership roles in the United States is notable. Women of color continue to be
underrepresented in senior leadership positions despite their ambition to advance and top
executives’ intention to achieve diversity in the executive suite. A systematic review examined
the factors that affect women of color on the path to senior leadership roles by analyzing and
synthesizing a dataset of 32 articles and by applying a theoretical framework of intersectionality
theory, institutional theory of diversity management, and resource-based theory of diversity
management. While this study’s findings show that effective diversity management practices are
linked to an increase in the number of women in senior leadership roles, it also showed that
women of color were disadvantaged in times of organizational crisis when access to senior
leadership afforded neither support nor tools to succeed. The data also found that women of color
in senior leadership roles had shorter tenure due to the scrutiny of their leadership, while those
who were supported by mentors and sponsors tended to be more successful. Women of color
relied on their own ingenuity to devise advancement strategies that allowed them to penetrate
institutional networks previously closed to them. It is recommended that managers assess the
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
ii
efficacy of existing and planned diversity management practices to find ways to maintain
corporate support for women of color aspiring to senior leadership, recognizing that this is a
critical component in increasing diversity amongst executives. One such practice is the creation
of pipeline programs that enable women of color to advance from middle to senior management
positions. Programs that train and promote women of color can also provide mentoring and
networking support for women of color committed to obtaining senior leadership positions.
Finally, among those who support executive diversity programs and diversity initiatives, it is
important to extend awareness on what is the road to success for women of color desiring senior
leadership roles.
Keywords: women of color, diversity management, glass cliff, advancement, senior
leadership, intersectionality theory, institutional theory of diversity management, and resource-based
theory of diversity management
FRACTURING THE CEILING: EXPLORING THE ORGANIZATIONAL FACTORS
IN THE
ADVANCEMENT OF WOMEN OF COLOR TO SENIOR LEADERSHIP
IN U.S. ORGANIZATIONS
by
Sharron Graves
Dissertation submitted to the School of Business,
University of Maryland Global Campus, in partial fulfillment
of the requirements for the degree of
Doctor of Business Administration
2021
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
ii
© Copyright by
[Sharron Graves]
2021
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
iii
To my mother, Sylvia Graves
You supported me with your prayers and guidance throughout the years and through this
dissertation. Your continued encouragement as I took this journey was more than I could have
asked for, and I am so grateful to have you in my life.
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
iv
Acknowledgements
The road to completion of this dissertation has been a wonderful, exciting journey, one I
did not take alone. I offer heartfelt thanks to my dissertation advisors, Dr. Deborah Wharff and
Dr. Joseph Drasin. Dr. Wharff, you are an amazing mentor, listener, counselor, coach, and
someone I now call friend. Your guidance throughout this process was nothing short of
phenomenal. From the start, you challenged me to dig deeper and to excel, demonstrating your
confidence in my abilities by setting the bar high and being there when I met the challenge. I am
fortunate to have taken this journey with you and extremely grateful for all of your support and
kindness along the way. Thank you, Dr. Drasin, for constantly asking the challenging questions.
They helped me stay grounded in my study, urging me to dig deeper and creating a stronger
foundation for my research. I am grateful to you both for guiding me as a scholarly practitioner.
I would like to acknowledge my cohort members. You were like a family in your support
and encouragement along the way. I am so fortunate to have met you and to have taken this
journey with you. I would like to thank Marina Caminis for her continued support and for
helping to make this journey enjoyable. Cynthia Thomes provided invaluable assistance with
library resources that contributed to the quality of work I was able to achieve. I would also like
to acknowledge the DBA faculty for providing a scholarly framework I could rely on when
researching and writing my dissertation.
I would like to thank members of my family and friends for all their support along the
way. I would especially like to acknowledge my nephew, Brandon Fields, who continually
encouraged me to keep going and supported my journey with prayer.
Most importantly, I want to thank my Lord and Savior, Jesus Christ, through whom I
receive all my blessings.
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
v
Table of Contents
Abstract ............................................................................................................................................ i
Acknowledgements ........................................................................................................................ iv
List of Tables ................................................................................................................................. ix
List of Figures ................................................................................................................................. x
Chapter 1: Introduction and Overview of the Management Problem ............................................. 1
Background .............................................................................................................................. 2
Problem Statement ................................................................................................................... 5
Research Purpose ..................................................................................................................... 7
Research Question .................................................................................................................... 8
Rationale for the Study ............................................................................................................. 9
Definitions and Terminology ................................................................................................. 10
Chapter Summary ................................................................................................................... 12
Organization of the Dissertation ............................................................................................. 13
Chapter 2: Scoping Literature Review and Theoretical Frame ..................................................... 14
Scoping Literature Review ..................................................................................................... 14
The History of Women in the Workforce ....................................................................... 15
Women and Women of Color on the Path to Leadership ............................................... 16
The Gender Gap .............................................................................................................. 18
The Ceiling Effects ......................................................................................................... 19
Intersectionality and Leadership ..................................................................................... 21
Diversity Management .................................................................................................... 22
Theoretical Framework and the Significance of Theory ........................................................ 24
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
vi
Intersectionality Theory .................................................................................................. 24
Institutional Theory of Diversity Management ............................................................... 26
Resource Based Theory of Diversity Management ........................................................ 27
Conceptual Framework .......................................................................................................... 29
Chapter Summary ................................................................................................................... 30
Chapter 3: Methodology ................................................................................................................ 31
Review Design ....................................................................................................................... 32
The Evidence-Based Research Framework .................................................................... 32
Systematic Review Process ............................................................................................. 34
Review Question and Methodology ....................................................................................... 35
Search Strategy and Search Terms .................................................................................. 36
Inclusion and Exclusion Criteria ..................................................................................... 38
Quality Appraisal Method of the Included Studies ................................................................ 39
PRISMA Diagram ................................................................................................................... 40
Analysis and Synthesis Methodology .................................................................................... 41
Coding Process ................................................................................................................ 44
Chapter Summary ................................................................................................................... 45
Chapter 4: Analysis and Findings .................................................................................................. 46
Description of the Data Set .................................................................................................... 46
Results of the Quality Appraisal of the Data Set .................................................................... 49
Data Extraction ....................................................................................................................... 53
Findings and Discussion Based on Synthesis and Analysis ................................................... 54
Coding Results ....................................................................................................................... 57
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
vii
Finding 1–Organizational Culture (Enablers) ................................................................. 58
Finding 2– Organizational Culture (Barriers) ................................................................. 59
Finding 3 – Policies and Initiatives (Enablers) ............................................................... 62
Finding 4 – Policies and Initiatives (Barriers) ................................................................ 64
Finding 5 – Individual Ingenuity (Enablers) ................................................................... 66
Finding 6 –Individual Ingenuity (Barriers) ..................................................................... 68
Revised Conceptual Model/Framework ................................................................................. 69
Chapter Summary ................................................................................................................... 70
Chapter 5: Conclusions and Implications ...................................................................................... 72
Review of the Research .......................................................................................................... 72
Answer to the Research Question .......................................................................................... 73
Summary of Findings ............................................................................................................. 73
Summary of Finding 1 (Enabler) .................................................................................... 73
Summary of Finding 2 (Barrier) ..................................................................................... 74
Summary of Finding 3 (Enabler) .................................................................................... 75
Summary of Finding 4 (Barrier) ..................................................................................... 75
Summary of Finding 5 (Enabler) .................................................................................... 76
Summary of Finding 6 (Barrier) ..................................................................................... 76
Overall Conclusion ................................................................................................................. 76
Management Implications (Recommendations) ..................................................................... 78
Limitations of the Study ......................................................................................................... 85
Areas for Future Research ...................................................................................................... 86
Final Summary and Conclusion ............................................................................................. 87
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
viii
References .................................................................................................................................... 89
Appendix A. UMGC OneSearch, Databases .............................................................................. 108
Appendix B. Articles in Systematic Review Dataset ................................................................. 109
Appendix C. Data Extraction Table ............................................................................................ 113
Appendix D. Summary of Articles in Findings, by Themes ...................................................... 130
Appendix E. Initial Codes and Code Groups ............................................................................. 137
Appendix F. Axial Codes from Second Cycle Coding ............................................................... 148
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
ix
List of Tables
Table 1. Systematic Review Process, Petticrew and Roberts ........................................................ 35
Table 2. Search Strategy, Library Search Terms and Search Location ........................................ 37
Table 3. Inclusion and Exclusion Criteria Used in the Systematic Review ................................. 38
Table 4. Weight of Evidence (WoE) Assessment Criteria ........................................................... 40
Table 5. Quality Assessment, Weight of Evidence (N=34) ......................................................... 53
Table 6. Findings With Supporting Studies ................................................................................. 57
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
x
List of Figures
Figure 1. CIMO logic ..................................................................................................................... 8
Figure 2. Initial Conceptual Model .............................................................................................. 30
Figure 3. PRISMA Flow Diagram for Reporting Items in Systematic Review Process .............. 42
Figure 4. Example of Article Assessed in Atlas.tiä 9 ................................................................. 43
Figure 5. Design Types Included in the Dataset, by Percentage of Total Design Types ............. 47
Figure 6. Number of Dataset Studies (N=32) Retrieved, by Search Location ............................. 48
Figure 7. Number of Studies Relevant to the Research Question, Scopus Database ................... 48
Figure 8. PRISMA Diagram Mapping the Systematic Review Database Search ........................ 50
Figure 9. Revised Conceptual Model ........................................................................................... 70
Figure 10. Diversity Management Learning Experience to Prepare Middle Managers for
Executive Roles ................................................................................................................... 82
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
1
Chapter 1: Introduction and Overview of the Management Problem
In today's more diverse workplace, the absence of women and other minorities in
executive roles is becoming a source of concern for leaders and stakeholders. Several measures
have been utilized by organizations to evaluate the extent and impact of diversity within their
ranks (Olsen & Martins, 2016) and to improve the hiring of women and other minority groups as
they develop a diverse workforce reflecting the nation's demographics (Sabharwal, 2014).
Organizations in the U.S. are adapting to the changing demographics of their workforce, but their
efforts to promote diversity at the executive level have largely excluded women of diverse racial
and ethnic backgrounds. To promote diversity at the senior executive level, middle management
needs more information about factors that impact the advancement of women of color to senior
leadership (Pace, 2018). These women have successfully progressed and advanced beyond the
roles of individual contributor and first-line manager. While there are organizational initiatives to
diversify personnel among the ranks in general, women of color remain underrepresented at the
highest management levels of the organization.
Women of color include “one, some, or all groups of women of racial/ethnic minority
backgrounds” (Luna, 2016, p. 773). For the purpose of this study, the focus will be on:
Black/African American, Hispanic/Latina, and Asian American women. Women of color strive
to be in top leadership positions where they can influence and lead with purpose (Pace, 2018),
yet, from the early twentieth century to today, they continue to face occupational and economic
disadvantages in the workplace because of how race and gender affect advancement (Wingfield,
2020). Women of color have made notable contributions to all sectors of the organization, but
their absence in senior leadership roles in the United States has been shown to be significant.
This is not attributable to a lack of ambition to move into executive management positions. An
FACTORS IN WOMEN OF COLOR SENIOR LEADERSHIP ADVANCEMENT
2
article in Harvard Business Review reported that 83% of Asian American women, 80% of Black
women, and 76% of Latinas expressed the desire to be promoted, while 75% of men and 68% of
white women (Schwantes, 2019) sought advancement. Women of color experience more barriers
to
Leadership rhetoric for collaboration between project management offices and communities of practice in project-based organizations – A systematic review
No full textThis study explores the following research question: In a project-based organization implementing both project/program management offices (PMOs) and communities of practice (CoPs), which leaders should use rhetoric, and what approaches work best to generate collaborative contributions to the organization's strategic knowledge management? The research considered the scenario where an organization has already implemented a PMO and a CoP, and leaders are responsible for fostering collaboration to generate collaborative contributions to strategic knowledge management. The methodology for the study was a systematic review consisting of a search for articles, quality appraisal, data extraction, and three-phase thematic synthesis.
Three primary insights into the effectiveness of rhetoric emerged from the systematic review of the literature: 1) Without rhetoric from executive sponsors, individuals are not motivated to share knowledge, 2) Rhetoric from executive sponsors reduces barriers to strategic knowledge management, 3) Group leader rhetoric also is critical for strategic knowledge sharing. The study provides recommendations based on these findings.LEADERSHIP RHETORIC FOR COLLABORATION i
Abstract
Title of Dissertation:
LEADERSHIP RHETORIC FOR COLLABORATION BETWEEN PROJECT MANAGEMENT OFFICES AND COMMUNITIES OF PRACTICE IN PROJECT-BASED ORGANIZATIONS - A SYSTEMATIC REVIEW
Tona Trice, Doctor of Business Administration, 2022
This study explores the following research question: In a project-based organization implementing both project/program management offices (PMOs) and communities of practice (CoPs), which leaders should use rhetoric, and what approaches work best to generate collaborative contributions to the organization's strategic knowledge management? The research considered the scenario where an organization has already implemented a PMO and a CoP, and leaders are responsible for fostering collaboration to generate collaborative contributions to strategic knowledge management. The methodology for the study was a systematic review consisting of a search for articles, quality appraisal, data extraction, and three-phase thematic synthesis. LEADERSHIP RHETORIC FOR COLLABORATION
ii
Three primary insights into the effectiveness of rhetoric emerged from the systematic review of the literature: 1) Without rhetoric from executive sponsors, individuals are not motivated to share knowledge, 2) Rhetoric from executive sponsors reduces barriers to strategic knowledge management, 3) Group leader rhetoric also is critical for strategic knowledge sharing. The study provides recommendations based on these findings.
Keywords: leadership, project management offices, communities of practice, strategic knowledge management, project-based organizations LEADERSHIP RHETORIC FOR COLLABORATION
iii
LEADERSHIP RHETORIC FOR COLLABORATION BETWEEN PROJECT MANAGEMENT OFFICES AND COMMUNITIES OF PRACTICE IN PROJECT-BASED ORGANIZATIONS: A SYSTEMATIC REVIEW
By
Tona Trice
Dissertation submitted to the School of Business,
University of Maryland Global Campus, in partial fulfillment
of the requirements for the degree of
Doctor of Business Administration
2022 LEADERSHIP RHETORIC FOR COLLABORATION
iv
LEADERSHIP RHETORIC FOR COLLABORATION
v
© Copyright by
Tona Trice
2022
LEADERSHIP RHETORIC FOR COLLABORATION
vi
Dedication
I dedicate this dissertation to the Lord, who set a path for me beyond anything I could have imagined.
I also dedicate this dissertation to my mother, who invested in me.
Finally, I dedicate this dissertation to my daughter, who inspired me. LEADERSHIP RHETORIC FOR COLLABORATION
vii
Acknowledgements
This dissertation is the culmination of a years-long effort. I would first and foremost like to thank the Lord who gave me strength to persevere through the learning process. I must also thank the team of advisors and mentors who contributed to the success of this work, including my dissertation mentors, Dr. Denise Breckon and Dr. Lisa Pearo. I would also like to thank UMGC Librarian Cynthia Thomes, whose expertise was instrumental in the success of this research.
LEADERSHIP RHETORIC FOR COLLABORATION
viii
Table of Contents
Abstract ......................................................................................................................................................... i
Dedication ................................................................................................................................................... vi
Acknowledgements .................................................................................................................................... vii
Table of Contents ...................................................................................................................................... viii
List of Tables ................................................................................................................................................ x
List of Figures .............................................................................................................................................. xi
Chapter 1: Introduction and Overview of the Management Problem ......................................................... 1
Knowledge Management and Strategic Knowledge Management ........................................................... 2
Knowledge Management and Leadership ............................................................................................ 4
Leading Effective Strategic Knowledge Management .......................................................................... 6
Rhetoric as a Tool for Leading Effective Strategic Knowledge Management ....................................... 7
Leading Knowledge Management Initiatives: PMOs and CoPs ............................................................ 8
Leading Collaboration Among PMOs and CoPs .................................................................................. 10
Problem Statement and Significance of the Problem .............................................................................. 13
Significance of the Problem ................................................................................................................ 13
Contribution to Managerial Knowledge ............................................................................................. 14
Purpose of the Study and The Research Question .................................................................................. 14
Definitions and Terminology ................................................................................................................... 15
Chapter Summary................................................................................................................................... 16
Organization of the Dissertation ............................................................................................................. 16
Chapter 2: Scoping Literature Review and Theoretical Frame ................................................................... 17
The Literature Landscape ........................................................................................................................ 17
An Overview of PMOs ......................................................................................................................... 17
An Overview of CoPs ........................................................................................................................... 20
Theoretical Framework ........................................................................................................................... 21
Intergroup Leadership Theory (ILT) Overview .................................................................................... 22
Previous Research Using ILT ............................................................................................................... 25
Conceptual Model .................................................................................................................................. 27
Chapter Summary................................................................................................................................... 29
Chapter 3: Method ..................................................................................................................................... 30
Review Design and Methodology ............................................................................................................ 30
The Evidence-Based Research Framework ......................................................................................... 31
Systematic Reviews ............................................................................................................................. 31
Systematic Review Process ................................................................................................................. 32
Search Strategy .................................................................................................................................. 32
Search Terms ...................................................................................................................................... 33
Inclusion and Exclusion Criteria .......................................................................................................... 34
Method of Quality Appraisal of the Included Studies ......................................................................... 34
PRISMA Diagram ................................................................................................................................ 35
Analysis and Synthesis Methodology ...................................................................................................... 36
Coding Process ................................................................................................................................... 37
Chapter Summary................................................................................................................................... 38
Chapter 4: Analysis and Findings ................................................................................................................ 39 LEADERSHIP RHETORIC FOR COLLABORATION
ix
Review of the Research Question............................................................................................................ 39
Description of the Dataset....................................................................................................................... 39
Results of the Quality Appraisal of the Dataset ....................................................................................... 41
Findings and Discussion ........................................................................................................................... 42
Descriptive Themes ............................................................................................................................. 45
Analytical Themes ............................................................................................................................... 45
Summary of Findings ............................................................................................................................... 56
Chapter Summary................................................................................................................................... 57
Chapter 5: Conclusions and Implications .................................................................................................... 58
Review of the Research ........................................................................................................................... 58
Answer to the Research Question ........................................................................................................... 60
Management Implications and Recommendations ................................................................................. 60
Recommendation 1 ............................................................................................................................. 60
Recommendation 2 ............................................................................................................................. 61
Recommendation 3 ............................................................................................................................. 62
Limitations of the Study .......................................................................................................................... 63
Areas for Future Research ....................................................................................................................... 64
Final Summary and Conclusion ............................................................................................................... 64
References ................................................................................................................................................. 66
Appendix A ................................................................................................................................................. 84
Appendix B ................................................................................................................................................. 85
Appendix C ................................................................................................................................................. 96
LEADERSHIP RHETORIC FOR COLLABORATION
x
List of Tables
Table 1 ........................................................................................................................................................ 15
Table 2 ........................................................................................................................................................ 42
Table 3 ........................................................................................................................................................ 44 LEADERSHIP RHETORIC FOR COLLABORATION
xi
List of Figures
Figure 1 ...................................................................................................................................................... 24
Figure 2 ...................................................................................................................................................... 27
Figure 3 ...................................................................................................................................................... 36
Figure 4 ...................................................................................................................................................... 40
Figure 5 ...................................................................................................................................................... 40
Figure 6 ...................................................................................................................................................... 41
Figure 7 ...................................................................................................................................................... 41
Figure 8 ...................................................................................................................................................... 59
LEADERSHIP RHETORIC FOR COLLABORATION
1
Chapter 1: Introduction and Overview of the Management Problem
Since the introduction of project-based organizations (PBOs) in the organizational management literature in the 1990s, the number of project-based organizations has increased steadily (Miterev et al., 2017). The definition of a PBO has varied over time. For this dissertation, a PBO is defined as an organization that uses project management structures to organize business processes, including functional business processes like human resources and financial management (Miterev et al., 2017). In this context, internal projects support core business functions and are used to achieve internal business goals (Lundin et al., 2015). The project-based structure in PBOs presents two options for knowledge management: management as a project within a dedicated business unit, or management as a task within a permanent organizational structure (Turner & Miterev, 2019). In cases where the organization implements knowledge management initiatives within separate business units, the organization faces challenges in cross-unit collaboration to support strategic knowledge management.
PBOs implement a variety of knowledge management initiatives focused on different aspects of knowledge management. The Project Management Institute Agile Discipline Framework (2020), an authoritative resource on project management, recommended organizations implement both project/program management offices (PMOs) and communities of practice (CoPs) to continually improve business performance through sharing improvements. In PBOs, PMOs are created to standardize project management methodologies and ensure best practices are implemented across the organization (PMI, 2021). CoPs are created to ensure individuals share knowledge and best practices across project teams (PMI, 2020). Strategic knowledge management requires organizations to foster collaboration among PMOs and CoPs.
However, research has shown that the organizational factors conducive to PMOs are often less effective for CoPs and vice versa. Thus, leaders in PBOs face the challenge of fostering collaboration among PMOs and CoPs to produce contributions to strategic knowledge management. Rhetoric, defined LEADERSHIP RHETORIC FOR COLLABORATION
2
as persuasive communications designed to influence actions, is a tool that leaders use to create, sustain, or challenge order within their organizations (Browning & Hartelius, 2018). Therefore, this dissertation presents evidence-based recommendations on which leaders should use rhetoric and what approaches work best to foster collaboration among PMOs and CoPs to produce contributions to strategic knowledge management. This research explores who uses rhetoric, when, where, and for what purpose (Sillince & Golant, 2018) in order to advance scholarship on knowledge management in PBOs and assist practitioners in leading strategic knowledge management in PBOs.
Knowledge Management and Strategic Knowledge Management
Despite being a relatively new study area, knowledge management is an essential topic in modern management studies. The role of knowledge in business performance and productivity gained importance in the 1960s, and by the early 2000s, academic research addressed knowledge management as a critical factor in organizational success (Serenko, 2013). In the 2010s, academic research focused on the complexities of the knowledge management domain (Serenko & Bontis, 2013). By 2019, knowledge management had matured into a formal academic discipline (Serenko, 2021). A trend in recent literature is the use of knowledge management as a lens to examine organizational problems and the use of theoretical frameworks from the field of knowledge management to explain business outcomes such as innovation and performance (Gaviria-Marin et al., 2019). Thus, the concept of knowledge management is continually evolving through ongoing research. The continual evolution of knowledge management has increased the importance of the topic while muddying definitions of key constructs.
Deconstructing the phrase knowledge management provides clarity. The phrase "knowledge management" combines two concepts: knowledge and management. Knowledge refers to an organizational resource for competitive advantage (Hammoud, 2020). Management refers to formal measures for the explicit control of knowledge resources, including components of knowledge creation, validation, presentation, distribution, and application (Bhatt, 2001). The focus on knowledge as a LEADERSHIP RHETORIC FOR COLLABORATION
3
resource and the management of knowledge as a resource distinguishes knowledge management from related concepts like organizational learning that focus on the learning process (Hammoud, 2020). Thus, knowledge management provides insights into how organizations exercise control over knowledge resources and includes control through leadership, management, policies, information technologies, and other methods.
Despite the diversity of methods explored in the knowledge management literature, research on knowledge management has converged. There are three main clusters of research: knowledge transfer within strategic alliances to enhance organizational capabilities, management practices to enhance knowledge creation and capture, and factors influencing knowledge management and organizational performance (Shashi et al., 2021). The first two clusters of research examine how knowledge management achieves these and include research on success factors. The third cluster of knowledge management research focuses on business outcomes. Knowledge management activities do not always produce business outcomes such as increased financial performance or competitiveness (Andreeva & Kianto, 2012). Thus, research on knowledge management initiatives' practice and success factors is separate from research on knowledge management as a tool to achieve business outcomes. Focusing on business outcomes like financial performance provides the foundation for strategic knowledge management.
A significant difference between knowledge management and strategic knowledge management is that strategic knowledge management explicitly addresses business outcomes like organizational performance and other strategic objectives. Resea