Perceptions of Ethical Leadership and the Ethical Environment and Culture: IntegratedEthicsTM Staff Survey Data from the VA Health Care System

Abstract

Background: To enhance understanding of ethical leadership and the ethical environment and culture (EL/EEC) in the Department of Veterans Affairs (VA) health care system, we mapped selected questions from the VA IntegratedEthics™ Staff Survey (IESS), a national survey of employees’ perceptions of ethical practices, to the Ethical Leadership Compass Points (ELC), a tool to help leaders cultivate an environment and culture that makes it easy for employees to “do the right thing.” The ELC distills insights and principles from organizational and business ethics and provides leaders with specific behaviors that can be incorporated into daily administrative routines. Methods: We analyzed the responses of 88,605 VA employees to the 2010 IESS questions that previously were mapped to the ELC. Descriptive statistics were used to characterize overall distribution of responses to the survey questions, and Pearson's chi-squared tests were performed to assess differences in responses by employee characteristics. Multiple regression analyses examined the association between perceptions of EL/EEC and perceptions of the organizations’ overall ethics quality. Results: Physicians and employees with a higher level of supervisory responsibility were more likely to have the most positive perceptions of EL/EEC and the organization's overall ethics quality. More than three-quarters of the variation in perceptions of overall ethics quality was explained by employee perceptions of EL/EEC. The IESS questions that showed the largest associations with perceptions of overall ethics quality addressed fair allocation of resources across programs and services, avoidance of mixed messages that create ethical uncertainty or conflict, fair treatment of employees, and following up on ethical concerns reported by employees. Conclusions: These results support the important relationships between ethical leadership, an organization's environment and culture, and overall ethics quality. Certain ethical leadership practices may have a larger impact on employees’ perceptions of overall ethics quality than others.