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The extant leadership research has paid increasing attention to the concept of motivation to lead (MTL) as an individual construct that strongly affects leadership processes and behaviors. However, despite its importance, scant knowledge is available about how individual characteristics and organizational structural features interact in influencing MTL in professional-based organizations. This article contributes to this line of research by adopting a multilevel perspective to study the MTL among individual professionals in the healthcare sector. We collected data from a sample of 791 physicians nested in 44 departments belonging to 27 hospitals. Using the hierarchical linear model, we tested the impact of individual and organizational variables on the motivation of physicians to engage in managerial positions. Our findings demonstrate that the physicians' MTL was positively associated with their individual self-efficacy. Departmental decentralization interacted with this self-efficacy, such that the effect of self-efficacy on the MTL was significantly lower when decentralization was high. We discuss the implications of these findings for human resource management and organizational (re)design within professional organizations. info:eu-repo/semantics/publishedVersion

BACKGROUND:: The interest toward hospital restructuring has risen significantly in recent years. In spite of its potential benefits, often organizational restructuring in health care produces unexpected consequences. Extant research suggests that institutional theory provides a powerful theoretical lens through which hospital restructuring can be described and explained. According to this perspective, the effectiveness of change is strongly related to the extent to which innovative arrangements, tools, or practices are adopted and implemented within hospitals. Whenever these new arrangements require a substantial modification of internal processes and practices, resistance to implementation emerges and organizational change is likely to become neutralized. PURPOSE:: This study analyzes how hospital organizations engage in decoupling by adopting but not implementing a new organizational model named clinical directorate. METHODOLOGY:: We collected primary data on the diffusion of the clinical directorate model, which was mandated by law in the Italian National Health Service to improve hospital services. We surveyed the adoption and implementation of the clinical directorate model by monitoring the presence of clinical governance tools (measures for the quality improvement of hospital services) within single directorates. In particular, we compared hospitals that adopted the model before (early adopters) or after (later adopters) the mandate was introduced. FINDINGS:: Hospitals were engaged in decoupling by adopting the new arrangement but not implementing internal practices and tools for quality improvement. The introduction of the law significantly affected the decoupling, with late-adopter hospitals being less likely to implement the adopted model. PRACTICE IMPLICATIONS:: The present research shows that changes in quality improvement processes may vary in relation to policy makers' interventions aimed at boosting the adoption of new hospital arrangements. Hospital administrators need to be aware and identify the institutional changes that might be driven by law to be able to react consistently with expectations of policymakers. Copyright © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.