The purpose of this study was to explore perceptions of work environment characteristics across employee groups in a rural hospital to determine if authentic leadership and management practices were perceived to be actualized in the organization. Creating a healthy work environment through authentic leadership practices is critical to sustaining care quality improvements (QIs) and patient safety. In light of fewer financial and educational resources, an academic-practice partnership provides evidencebased support for administrators in rural hospitals. This mixed methods study involved the following measures: 1) Descriptive cross-sectional survey of hospital employees regarding work environment characteristics (N = 139/188; 74% response rate), yielding statistical power of .95, and 2) multiple qualitative focus groups with employees (N = 37) to explore contextual factors potentially influencing perceptions of work environment. There were statistically significant differences among perceived levels of vitality for hospital administrative staff compared to clinical and ancillary staff (p < .000 – p < .026). Thematic content of qualitative data revealed issues regarding a perceived lack of authentic leadership and management behaviors. Adopting best practices related to QIs may first require a paradigm shift by hospital leadership and management through conscious promotion of mutual trust and healthy work behaviors. An academic-practice partnership can provide data-based insights into work environment characteristics that may need attention so that the hospital administrator may empower staff-driven, collaborative QIs from an evidence-based stance.