Date of Award


Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Jami Jones

Second Advisor

Abby Swanson Kazley

Third Advisor

Jim Dunn


The uncertainty of healthcare, unrelenting cost containment pressures, market competition dynamics and increasing regulatory requirements pose significant challenges for survival for healthcare systems. The objective of this study is to determine the key leadership characteristics and attributes of strategy implementation a leader must have to survive the turbulence of healthcare. The study is designed as a qualitative study using the PRISMA model for systematic and meta-analytic review methods. Using grounded theory, the literature was coded using the Derue et al. integrated model for leadership traits and behaviors to identity key leadership characteristics. The literature was additionally coded using John Kotter’s change model to identity critical features of strategy implementation. NVivo qualitative analysis software was used to find overlaps in the literature. Search results returned 38 titles following applications of inclusion and exclusion criteria of which 1,165 references were coded. The most prevalent leadership characteristics and behaviors with a causal relationship to leadership effectiveness found in the text included: relational-oriented leadership (38%), task-oriented leadership (18%) and task competence (16%). The predominant themes of strategy implementation included: anchoring change in culture (33%), empowering action (22%) and developing a vision and strategy (20%). Leadership characteristics and features of strategy implementation overlapped most between relational-oriented leadership and anchoring change (146 references), relational-oriented leadership and empowering action (120 references), relational-oriented leadership and creating a guiding coalition (89 references), task-oriented leadership and developing a vision and strategy (71 references) and task-oriented leadership and anchoring change (69 references).


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