Leadership and Better Patient
Care: From Idea to Practice
Organisational Climate Survey
Professor Paula Nicolson
Department of Health and Social Care
Royal Holloway, University of London
Room 21A,
11, Bedford Square,
London WC1B 3RF
E-mail: paula.nicolson@rhul.ac.uk
Leadership and Better Patient Care: From Idea to
Practice
You are being invited to take part in a research study, funded by the NHS Service
Delivery and Organisation Research and Development Programme being conducted
by a team of researchers from Royal Holloway, University of London. This research
explores how leadership is transmitted through health service organisations to affect
service delivery in three different hospital settings.
Before you decide to participate in this study it is important for you to understand why
the research is being done and what it will involve.
Please feel free to contact the Principal Investigator, Professor Paula Nicolson at
Paula.Nicolson@rhul.ac.uk or at 0207 307 8616 (office) or 07931 797 485 (mobile) if
there is anything that is not clear or if you would like more information.
Study Purpose:
The purpose of this study is to try to identify the circumstances under which
leadership can be an effective agent for change in the organization of health care,
especially for patient care and service delivery. Although we suspect that leadership
motivates workers and affects a workplace’s climate or atmosphere, leadership can
mean different things to different people. The same is true for the concept of patient
care. Thus, in order to understand how leadership inspires health workers to provide
better patient care, we want to learn how patients, nurses, other related medical
professionals and managers define and understand leadership and patient care. This
includes exploring how their definitions and perceptions mesh or conflict with one
another. We plan to explore these concepts by using focus groups, questionnaires,
interviews and direct observations. Some participants will be taking part in more than
one data gathering activity.
Participation in this study is voluntary and all information will be kept confidential.
Although we are keen to obtain information from all currents of opinion, it is entirely
up to you to decide whether or not to take part. If you decide to participate, you are
still free to withdraw at a later stage if you so wish. Data from this research will be
treated in the strictest confidence. It will be stored in a database at the college. Names
will be removed from all data and identification numbers will be assigned for the
purpose of re-contacting individuals for further data collection after the observation
part of the study is complete. Access to the direct data will be entirely limited to the
members of the research team.
Although we cannot promise this study will directly help you, it is intended that our
findings will be used to improve the quality of patient care provided by the NHS.
Once the study has concluded the Royal Holloway team will organise a conference on
research and evaluation in the NHS specifically to disseminate these findings. We will
also present our findings to the participating NHS Trusts by organising seminars
discussing specific aspects of the research and will seek to work with the NHS
Leadership Centre, the NHS Institute for Innovation and Improvement to disseminate
the findings to a wider NHS audience. Additionally we plan to present our findings
and analysis in professional Journals and professional conferences.
Names and titles of all the grant-holders:
Professor Paula Nicolson
Professor Yiannis Gabriel
Dr. Kristin Heffernan
Mr. Christopher Howorth
Dr. Graham Smith
Researchers
Dr. Rebekah Fox
Ms. Emma Rowland
A box here where the Hospital
and the Unit will be coded for
purposes of analysis
Professor Paula Nicolson
Department of Health and Social Care
Royal Holloway, University of London
Room 21A,
11, Bedford Square,
London WC1B 3RF
Email: paula.nicolson@rhul.ac.uk
Organisational Climate Survey: Staff
Thank you for agreeing to participate in this study which as you will know is part of a
larger study exploring leadership and patient care in the NHS.
The following questions explore how NHS workers feel about their jobs, how their
jobs are managed and how things generally work in their organisations.
The survey is anonymous, so please do not put your name on the survey but please put
the name of your hospital..
If, however, you would like to receive the final results of the survey when the study is
completed, please fill in the tear-out form on the questionnaire’s last page and submit
it to the researcher or directly to Professor Paula Nicolson the principal investigator.
It is important that you answer all the questions. This should take you approximately
20 minutes. Where you are asked to choose between answers, please follow the
instructions to select the response that best represents your current work situation.
Your individual responses will be kept strictly confidential.
Please return the completed questionnaire as an e-mail attachment to
paula.nicolson@rhul.ac.uk The e-mail will be deleted as soon as the questionnaire has
been downloaded.
Part 1: The name of my hospital:
1.
How would you describe your job title in the unit?
________________________________________________________________
2.
How would you describe your current responsibilities in the unit?
________________________________________________________________
3.
How long have you been working for your organisation (NHS)?
less than 1 year
1 - 5 years
over 5 years (please specify _____________ )
4.
How long have you been working at your hospital?
less than 1 year
1 - 5 years
over 5 years (please specify _____________ )
5.
How long have you been working in the unit?
less than 1 year
1 - 5 years
over 5 years (please specify _____________ )
6.
How long have you been in your current job?
less than 1 year
1 - 5 years
over 5 years (please specify _____________ )
Part 2:
For each of the following statements in Part 2 please use the following scale:
1 = If you DEFINITELY DISAGREE; that is, if the statement definitely does NOT
express how you feel about the matter.
2 = If you are INCLINED TO DISAGREE; that is, if you are not definite, but think
that the statement does NOT tend to express how you feel about the matter.
3 = If you are INCLINED TO AGREE; that is, if you are not definite, but think that
the statement tends to express how you feel about the matter.
4 = If you DEFINITELY AGREE; that is, if the statement definitely expresses how
you feel about the matter.
INCLINED
DEFINITELY TO
DISAGREE
DISAGREE
7. In this
organisation, the
rewards and
encouragement I
get usually
outweigh the
threats and
criticism I get.
8. I feel that I am
a member of a
well-functioning
team.
9. In some of the
duties I’ve had to
perform in my
position, I haven’t
been sure exactly
who my
supervisor was.
10. Around here
management does
not want you to
check everything
with them. If you
think you’ve got
the approach
right you just go
ahead.
INCLINED
TO
AGREE
DEFINITELY
AGREE
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
INCLINED
DEFINITELY TO
DISAGREE
DISAGREE
11. In this
organisation,
people are
rewarded in
proportion to the
excellence of their
job performance.
12. The jobs in
this organisation
are clearly
defined and
logically
structured.
13. In this
organisation we
set very high
standards for
performance.
14. People in this
organisation
don’t really trust
each other.
15. In this
organisation, it is
sometimes
unclear who has
the formal
authority to make
a decision.
16. Our
management
believes that no
job is so well done
that it couldn’t be
done better.
17. Generally, I
am highly
committed to the
goals of this
organisation.
INCLINED
TO
AGREE
DEFINITELY
AGREE
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
INCLINDED
DEFINITELY TO
DISAGREE
DISAGREE
18. Around here
there is a feeling
of pressure to
continually
improve our
personal and
group
performance.
19. We don’t rely
too heavily on
individual
judgment in this
organisation;
almost everything
is doublechecked.
20. You don’t get
much sympathy
from those
higher-up in this
organisation if
you make a
mistake.
21. Around here
we take pride in
belonging to this
organisation.
22. When I am on
a difficult job /
case /assignment,
I can usually
count on getting
assistance from
my supervisor.
23. When I am on
a difficult job /
case /assignment,
I can usually
count on getting
assistance from
my co-workers.
24. There is not
enough reward
and recognition
given in this
organisation for
doing good work.
INCLINED
TO
AGREE
DEFINITELY
AGREE
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
INCLINDED
DEFINITELY TO
DISAGREE
DISAGREE
25. Our
philosophy
emphasises that
people should
solve their
problems by
themselves.
26. We have a
promotion system
here that helps
the best person
rise to the top.
27. Our
productivity
sometimes suffers
from lack of
organisation and
planning.
28. I don’t really
care what
happens to this
organisation.
29. You don’t get
ahead in this
organisation
unless you stick
your neck out and
try things on your
own.
30. As far as I can
see there isn’t
much personal
loyalty to the
organisation
around here.
31. In this
organisation
people don’t seem
to take much
pride in their
performance.
INCLINED
TO
AGREE
DEFINITELY
AGREE
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
Part 3:
In this section of the survey you are asked to assess the practices of your manager.
That is either the person to whom you directly report or the person who carries out
your performance appraisal. [please decide who is relevant for each question]
The following statements describe how a manager might perform in her or his job.
Please indicate how much you agree or disagree with each of the statements about
your manager by circling the appropriate number.
My Manager:
STRONGLY
DISAGREE
DISAGREE
____________
32. Establishes
clear, specific
performance
goals for me
in my work.
33. Is
supportive
and helpful to
me in my dayto-day
activities.
34. Sets
challenging
performance
goals and
standards for
me.
35.
Encourages
me to initiate
tasks or
projects I
think are
important.
36.
NEITHER
AGREE
NOR
DISAGREE
AGREE
STRONGLY
AGREE
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Communicates
excitement and
enthusiasm
about our
work.
My Manager:
STRONGLY
DISAGREE
DISAGREE
____________
37. Conducts
team meetings
in a way that
builds trust
and mutual
respect.
38.
Recognises
me for good
performance
more often
than he or she
criticises me
for poor
performance.
39. Clarifies
who is
responsible
for which
duties within
our work
group.
40.
Encourages
innovation
and
calculated
risk taking.
41. Relates the
total reward
system
(compensatio
n, recognition,
promotion) to
the excellence
of job
performance
rather than to
other factors
such as
seniority,
personal
relationships,
etc.
NEITHER
AGREE
NOR
DISAGREE
AGREE
STRONGLY
AGREE
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
My Manager:
STRONGLY
DISAGREE
DISAGREE
____________
42.
Demonstrates
personal
commitment
to achieving
goals.
43.
Encourages
me to
participate in
making
important
decisions.
44. Uses such
methods as
recognition
and praise to
reward
subordinates
for excellent
performance.
45. Makes
sure tasks and
projects are
clearly and
thoroughly
explained and
understood
when they are
assigned.
46. Involves
people in
setting goals.
47. Gives me
feedback on
how I am
doing my job.
NEITHER
AGREE
NOR
DISAGREE
AGREE
STRONGLY
AGREE
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
My Manager:
STRONGLY
DISAGREE
DISAGREE
____________
48. Expects
me to find
and correct
my own
errors rather
than doing
this for me.
49. Supports
and defends
me to his or
her superiors
when she or
he feels that I
am right.
50. I am
satisfied with
the quality of
leadership
that I get
from my
immediate
supervisor.
NEITHER
AGREE
NOR
DISAGREE
AGREE
STRONGLY
AGREE
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Part 4:
51. Are you male or female?
male
female
52. In which year were you born?
53. What is your marital or civil partnership status?
Single
Co-habiting
Married
Divorced
54. How many children do you have?
____________________________________
55. How would you describe your ethnic background?
56. What is you current salary?
1.
2.
3.
4.
5.
Less than £20,000 per annum
Between £21,000 and 39,000 per annum
Between £40,000 and £59,000 per annum
Between £60,000 and £99,000 per annum
Above £99,000 per annum
Thank you again for your time. If you have any questions please speak with the
researcher or alternatively you can contact Professor Paula Nicolson.
I would like to receive the final results of the survey when the study is completed
Name:
Address:
Contact Telephone:
Please return this form to either the researcher or Professor Paula Nicolson