Casting a vote for middle managers as most valuable players (MVPs) in shaping how health care employees feel about top leaders and workgroup performance.

BACKGROUND: Evidence indicates inclusive leadership as an effective strategy for improving health care organizational functioning and effectiveness; however, little is known about whether individuals in different leadership positions (middle managers versus top organizational leaders) shape employee perceptions of leader inclusiveness and workgroup performance. PURPOSES: This study examined whether middle manager inclusiveness influences employee perceptions of top leadership, and if middle manager and/or top leader inclusiveness influences perceptions of workgroup performance. METHODOLOGY/APPROACH: Data were collected at three points in 6-month intervals from a US hospital department. Response rates ranged from 71% to 74% (213-245 health care employees). Longitudinal multilevel path analyses were used to answer hypotheses. FINDINGS: A positive relationship was found between perceived middle manager inclusiveness at Time 1 and employee perceptions of top leader inclusiveness at Time 2 (6 months later). The inverse relationship was not supported (top leader inclusiveness at Time 1 was not related to perceptions of middle manager inclusiveness at Time 2), suggesting the critical role of middle managers as sensegivers for how employees perceive top leader inclusiveness. Top leader and middle manager inclusiveness positively influenced perceptions of workgroup performance at Time 3. PRACTICE IMPLICATIONS: While top leaders' and middle managers' inclusiveness positively influences employee perceptions of workgroup performance, middle managers serve as the most valuable players in shaping employee perceptions. Organizations that align their resources to target inclusive leadership development at the middle manager level can have a dual impact on improving perceptions of top leadership and middle management inclusiveness, ultimately enhancing perceptions of workgroup performance.