Date of Conferral



Doctor of Business Administration (D.B.A.)




D'Marie M. Hanson


In 2013, 1% of Medicare reimbursements were withheld from U.S. hospitals, with a

proposed cap of 2% in 2017 for redistribution to those hospitals that improve overall care and patient satisfaction. The purpose of this single case study was to explore the engagement strategies that some hospital middle managers used to improve employee performance to increase patient satisfaction. The sample included 4 health care middle managers in 1 hospital in northeast Connecticut. The conceptual framework that grounded this study was Kahn's personal engagement theory. Data were collected via semistructured interviews, participant observations, and review of hospital and public government documents. The process of member checking and methodological triangulation contributed to the study validity. The data were analyzed using Yin's 5-step method of analysis. Themes that emerged from the study were the importance of the role of the manager in fostering employee engagement, implementing explicit communication techniques, assisting employees in role performance, promoting employee wellbeing, commitment to patient care and satisfaction, and providing employees with rewards and recognition. Although this was a single case study, health care managers from other hospitals could benefit from the results of this study. The implications for social change include the potential for hospital managers to implement strategies to improve employees' engagement, thus improving patients' care and satisfaction, and the overall health and wellness of individuals in the community.