• Sabine Boerner and Elisabeth Dütschke.
• Department of Politics and Management, University of Konstanz, Germany. sabine.boerner@uni-konstanz.de
• Health Care Manage Rev. 2008 Oct 1; 33 (4): 332-40.

BackgroundOrganizations in the health care sector are undergoing extensive structural reforms. To face these challenges, management initiatives that foster employees' commitment to and support for organizational change are needed in hospitals.PurposesIn literature, a charismatic leadership style has proved to be especially helpful in times of crisis and change as well as an essential antecedent of followers' discretionary behavior in organizations. Thus, the aim of the study was to investigate charismatic leadership as a means to enhance followers' initiative-oriented behavior in hospitals. In the hospital context, two situational conditions have to be taken into account. We hypothesized that both employees' job autonomy and stress in the workplace will moderate the positive relationship between charismatic leadership and followers' initiative-oriented behavior.Methodology/ApproachWe investigated 543 members of medical staff (physicians and nurses) in six German hospitals by using a questionnaire. The hypotheses were tested by conducting hierarchical regression analyses and interpreting main effects and interactions effects.FindingsCharismatic leadership significantly predicted followers' initiative-oriented behavior. Moreover, our study confirmed the moderating effect of job autonomy. However, the moderating effect of followers' stress was not confirmed by our data.Practice ImplicationsFirst, the results of our investigation point at the positive impact that charismatic leaders have on followers' initiative-oriented behavior in the hospital. Several studies have shown that training can improve leaders' abilities in charismatic leadership. Thus, a suggestion for supervisor development from this is not only to provide professional training but also to intensify efforts in training specialized on charismatic leadership. Second, to support followers' participation in change processes, hospital managers should consider if and how the degree of followers' job autonomy can be enhanced.

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