Empowered to perform: A multilevel investigation of the influence of empowerment on performance in hospital units

Psychological empowerment has been studied extensively over the past few decades in a variety of contexts and appears to be especially salient within dynamic and complex environments such as healthcare. However, a recent meta-analysis found that psychological empowerment relationships vary significantly across studies, and there is still a rather limited understanding of how empowerment operates across levels. Accordingly, we advance and test a multi-level model of empowerment which seeks to better understand the unique and synergistic effects between unit and individual empowerment in hospital units. Analysis of data involving 544 individuals in 78 units, collected from multiple sources over three different time periods, revealed that unit empowerment evidenced a synergistic interaction with individual-level psychological empowerment as related to individuals' job performance, as well as an indirect effect on performance via individual empowerment, while controlling for previous performance levels. Notably, these effects were significant at relatively high, but not at relatively low, levels of unit empowerment. Furthermore, we found that unit voice climate increased unit empowerment and thereby enhanced individual psychological empowerment. These findings suggest that, in complex and dynamic environments, empowering work units is an important means by which leaders can enhance individuals' performance.