The impact of leader member exchange quality and differentiation on counterproductive and citizenship behavior in health care teams

BACKGROUND

Organizational citizenship behavior (OCB) may increase service quality. In contrast, counterproductive work behavior (CWB) may undermine patient safety. Efforts to increase OCB and reduce CWB rely on a good understanding of their antecedents, yet there is a lack of research in health care to inform such endeavors.

PURPOSE

The aim of this study was to investigate the role of leadership, specifically leader-member exchange (LMX), in reducing CWB and increasing OCB in health care teams.

METHODOLOGY/APPROACH

Team survey data were collected from 75 teams in U.S. health services organizations. Polynomial regression and response surface analysis was used to investigate our hypotheses.

RESULTS

For OCB, the response surface along the line of incongruence (a3) was positive and significant, and for CWB, a3 was negative and significant.

CONCLUSION

The results of polynomial regression and response surface analysis indicate that OCB increases when LMX quality is high and that LMX differentiation is comparatively lower. In contrast, CWB increases when LMX differentiation is high, whereas LMX quality is lower.

PRACTICE IMPLICATIONS

These findings provide useful suggestions to promote valuable extra-role behaviors in health care teams. Health care team leaders should aim to develop strong exchange relationships with all members if they wish to increase citizenship behavior and decrease counterproductive behavior. Building positive exchange relationships with only a few team members is likely to undermine citizenship behavior and increase counterproductive behavior.

Current Approaches, Typologies and Predictors of Deviant Work Behaviors: A Scoping Review of Reviews

This study provides a scoping review of the recent conceptual developments about the deviant work behavior and counterproductive work behavior constructs. It also examines the specific types of deviant work behavior that have been more consistently investigated in the last decade, and whether they cover the interpersonal or organizational type of deviant behavior. In addition, individual, group, and organizational predictors of deviant work behaviors are examined. A scoping review of reviews was conducted on Scopus and Web of Science databases and 54 studies published from 2010 to June 2021 were taken into account. Results show that more recent conceptualizations are based on well established models in the literature and consider the hierarchical structure of these two constructs. Recent reviews examine the relationships of deviant work behavior with job performance and ethical behavior constructs, the multilevel nature of deviant work behavior, and the consequences for the actor of the deviance. The specific types of deviant work behavior more frequently reviewed in the last decade are workplace abuse, incivility, ostracism, bullying and sexual harassment, and abusive and destructive leadership; this evidence suggests a much greater attention to interpersonal, rather than organizational, forms of deviant work behavior. Regarding antecedents, results show the continuing prevalence of personality factors antecedents. Limitations of the study and theoretical and practical implications for the field are also provided.