Date of Conferral



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


Business Administration


Franz Gottleib


Hospitals are in a precarious financial position with declining reimbursement, eroding profit margins, and low patient satisfaction. The Patient Protection and Affordable Care Act of 2010 reform may decrease hospital reimbursement by $500 billion from 2010 to 2020, while low patient satisfaction may decrease profitability for hospitals by 27%. Employee disengagement may decrease patient satisfaction and consumer loyalty. The purpose of this phenomenological study was to explore the lived experiences of health care leaders as they worked to engage employees and provide better patient care. Improving patient care provides opportunities to capture new market shares, which increases sustainability of health care organizations. Expectancy theory shaped the conceptual framework of this study. Inquiry consisted of personal interviews with 23 mid-level hospital managers. Data analysis occurred with a modified Van Kamm data analysis process, which entailed descriptive coding and sequential review of the interview transcripts. Member checks and data saturation ensured trustworthiness of the findings. The findings from these personal interviews led to discovery of 4 themes of leader-employee engagement to include psychological commitment, expectation realization, trust actualization, and reduction in the leadership power distance. By applying employee engagement strategies aligned with these themes, leaders may influence patient care. This study contributes to social change by increasing health care quality for patients leading to a positive influence on medical care and societal health.