Understanding Board Leadership: Adventist Hospital Board Chair Behaviors and Effectiveness and Organizational Outcomes

Document Type


Publication Date

Fall 2014


Each month, millions of board members meet to provide leadership to thousands of churches, hospitals, schools and other nonprofit organizations. Their decisions impact tens of millions of jobs and billions of dollars of allocation. However, there is very limited research on the leadership provided to these boards. This article reviews data collected from 123 board members serving 34 Adventist Health System hospitals. It asked them to provide their perceptions of their chair's leadership behaviors and effectiveness and compared that data to hospital outcome data in the form of patient satisfaction, clinical and financial data. Findings suggest that transformational behaviors and, to a lesser extent, transactional behaviors are central to members' perceptions of chair leadership effectiveness. To the contrary, chair laissez-faire leadership behaviors were viewed as ineffective. In addition, those chairs with more education were perceived as more effective and a higher level of chair education was a predictor of larger financial margins. Findings also suggest that younger chairs are a predictor of financially sound hospitals.

Journal Title

Journal of Applied Christian Leadership

Journal Title

Journal of Applied Christian Leadership





First Page


Last Page


First Department

Teaching, Learning and Curriculum

Second Department