The Impact of Communication and Collaboration in Hospitals From a Fiscal Leadership Perspective: A Qualitative Descriptive Study

Date of Award

Spring 2026

Document Type

Dissertation

Degree Name

Doctor of Business Administration (DBA)

Committee Chair

Kathy Richie

Committee Member

Wanda Fernandopulle

Committee Member

Usha Palaniswamy

Abstract

Fiscal leaders within the hospital system must communicate and collaborate with the clinical offices to better understand the needs of the front-line operations and provide great patient care. The problem lies in the relationship between the goals of two very different cultures of thinking, that of fiscal responsibility and clinical responsibility. If the process by which information is communicated is not adequate, the needed synergy will not be created to achieve the desired results. This research will aid healthcare leaders to better understand the disconnect in leadership communication in hospitals. Clear communication is essential for avoiding misunderstandings and encouraging collaboration between hospital departments to have a positive effect on patient care. This study helped answer the following research question: How do fiscal leaders describe how communication impacts the collaboration between fiscal and clinical management in hospitals? To address the research question in this proposed study, a qualitative descriptive methodology was appropriate. Twelve participants that worked in hospitals in fiscal management for the past 10 years participated in the study. Fiscal-Clinical Translation Gap, Fragmented Communication Between Departments, Executive Leadership Alignment, Financial Decisions Affecting Patient Care, Structured Coordination Mechanisms, Cultural Awareness in Hospital Leadership, and Fiscal Sustainability Supporting Healthcare Delivery were the seven themes created to identify patterns that helped answer the research question.

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