Journal
HUMAN RELATIONS
Volume 60, Issue 7, Pages 1065-1090Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0018726707081158
Keywords
change agency; change management; distributed leadership; healthcare; organizational change
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This article illustrates how distributed change agency can implement complex organizational changes in the absence of formal management plans, roles, and structures. Distributed change agency typically involves small teams and senior groups. In this qualitative study of service improvements in the treatment of prostate cancer at an acute hospital, Grange, change roles were distributed more widely, with responsibilities 'migrating' among a large informal cast supporting four central characters. This distribution appears to have been triggered by the change goals and substance, and by the network organization through which services were delivered. Cross-case comparisons with other hospitals, Henley and Norwood, suggest that a combination of factors contributed to the development of a distributed approach. Analytical generalization invites speculation concerning the transferability of this model, with 'nobody in charge', to other settings. One policy implication concerns the provision of development in change agency competencies to staff other than those in senior positions.
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