Hospital efficiency relates to organizational factors and leadership style. This study investigated several factors, as one interdependent construct, with the potential to influence hospital performance in terms of quality-of-care. National database and survey information on modern management, lean management, organizational traits and leadership was compared. A positive correlation was found between hospital performance and hospital type. Two negative correlations were found: one relating to the root cause of problems in the context of modern management style, and one relating to managerial responsibility in the context of lean (process) management style. No correlations were found with organizational factors or leadership. This study clarifies the relevance of several factors to hospital performance and highlights areas for further research on management systems, covering acute vs critical care and transformational vs transactional leadership, in order to identify drivers of performance in US hospitals.