The role of leadership–member exchange relationships in the implementation of the International Public Sector Accounting Standards by Greek public hospitals

Purpose: This paper aims to examine the quality of relations within upper-level management in Greek public hospitals (GPHs), as well as to specify the extent to which these facilitate or hinder the forthcoming International Public Sector Accounting Standards (IPSAS) adoption and implementation. Design/methodology/approach: A survey was conducted on a sample of 143 upper-management professionals drawn from across the 125 GPHs. A multivariate structural equation model (SEM) is used to investigate the degree of interdependence of the level of convenience of implementation under the view of the leader-member exchange (LMX) scale. Findings: The findings suggest that the established leader-member relations in the GPHs facilitate reforms. However, these relationships are of little benefit to IPSAS adoption and implementation mainly due to the low degrees of competence and commitment to IPSAS. The passive adoption of IPSAS is the most likely outcome. Originality/value: The study recontextualizes the LMX model to public sector research. The findings have value to hospital leadership and to policymakers, as well as to researchers studying the difficulties of IPSAS adoption and implementation.