Date of Degree


Document Type


Degree Name

Doctor of Philosophy (PhD)




Daniel Dominguez


David Fike


Kevin LaFrance


Absael Antelo


The health care delivery system in the United States has received increased attention over the last 2 decades. Concerns of access, choice, cost, and quality have been in the forefront. This study was conducted to assess the leadership behaviors of hospitals’ chief executive officers and how they impact the performance of hospitals. Two instruments were used to collect the data for the study: the Multifactor Leadership Questionnaire (MLQ-5X; Avolio & Bass, 2004) and a demographics questionnaire. A correlational research design was used to measure the degree of association between variables related to hospital CEOs, the hospitals they represented and hospital success as measured by operating margin and center of excellence designation. Hospitals with an operating margin of 8% or greater were considered successful as were hospitals with 2 or more centers of excellence. In assessing CEO leadership, the research focused on 9 MLQ-5X behaviors: 5 transformational, 2 transactional, and 2 laissez-faire. In this study, 2 transformational leadership behaviors, Idealized influence (IIB) and Inspirational motivation (IM) were found to be positively associated with operating margin. Further, for-profit hospitals had higher margins than non-profit hospitals and larger hospitals had a greater chance of having 2 or more modalities of excellence. Finally, hospitals with female CEOs had larger operating margins than those with male CEOs.