Paper
Saturday, 22 July 2006
This presentation is part of : Initiatives in Nursing Administration
An Investigation of Stakeholder Attributes, Salience and Extent of Involvement in Decisions Related to Strategic Change: Identifying a Voice for Nurses
Rhonda Foster, Vice President, Patient Care Services, Children's Hospital of Michigan, Detroit, MI, USA
Learning Objective #1: 1)Discuss principles of stakeholder theory and the importance of power, legitimacy, urgency, and voice in the process of involvement in decisions related to strategic change.
Learning Objective #2: 2)Describe how nurses can find and utilize their voice to enhance their perceived salience as primary stakeholders in the strategic decision-making process.
Nurses are affected daily by the decisions of executive leadership.  Making sound, ethical decisions is related to the inclusion of relevant stakeholders.  The purposes of this study were:  1) to apply stakeholder theory to investigate who healthcare chief executives viewed as primary stakeholders when making decisions regarding strategic change and 2) to determine the relationship between the identified primary stakeholders and the perceived attributes of legitimacy, urgency, power, and salience (the degree to which a stakeholder can succeed in getting its claims or interest ranked high by the decision-maker). A survey was adapted, pre-tested, then mailed to 752 CEO's of community hospitals in the U.S. 146 we returned; 142 were usable (return rate of 19%). Most respondents were males, 46-65 years of age who held masters' degrees.  Their mean tenure as CEO was 8.4 years with a mean of 25 years of professional experience. Results confirm a relationship between perception of attributes possessed by the stakeholder and the extent of involvement in decisions.  Stakeholders perceived to possess power, urgency, and salience were rated as having higher levels of involvement in the CEO's decision-making. However, the results of this study suggest a fourth attribute is also of prime importance; that of "voice". Hospital employees and staff were ranked behind governing board, medical staff, patients, and community residents in terms of being seen as the most important stakeholders. Perceptions did not vary by the CEO's tenure or years of healthcare experience. Although hospital employees were rated as high on legitimacy, they were not rated as high on power or urgency--both of which could have been enhanced by their utilizing the attribute "voice". The need for nurses to find and use their voice in enhancing their salience for healthcare decision-making will be discussed.

See more of Initiatives in Nursing Administration
See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)