Date of Award


Document Type


Degree Name

Doctor of Education (EdD)


Executive Leadership

First Supervisor

Theresa Pulos

Second Supervisor

Derrick Suehs


U.S. health care reform is a significant driver of complexity in healthcare organizations. The highly regulated directive began with the Affordable Care Act of 2008 and seeks to improve value of patient care by reducing costs and improving quality. However, to implement the required changes, executives must continue daily operations while they dismantle and reassemble core clinical and financial processes of the organization. The shift toward value exacerbates complexity in the already complicated and high stakes healthcare field. Complexity challenges improvement efforts and negatively impacts quality of care. Complexity also affects how executives make sense and lead. For success, executive leaders must understand the environment and maximize their influence as they balance operational logistics and cultural aspects of change. Cognitive and social-cognitive processes, such as sensemaking and sensegiving, play a pivotal role in how the leader calibrates a direction and influences the organization. This qualitative constructivist grounded theory study of 17 executive leaders explains the processes executives used to make sense and maximize influence in complex circumstances. The major finding in this study theorizes how sensesight, or insight emerging from sensemaking about sensegiving, maximizes influence during situational demands. The findings provide a theoretical model illustrating the processes and could benefit executives attempting to lead in complexity.

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