Leadership and Strategic Change under Ambiguity

This paper draws on a case study of a large public hospital to examine the processes of leadership and strategic change in organizations where goals are unclear and authority is fluid and ambiguous. The case history describes the evolution of leadership roles during a period of radical change in which a general hospital acquires a university affiliation while moving towards a more integrated form of management. The study traces the tactics used by members of the leadership group to stimulate change, and the corresponding impact of these tactics on both the progress of change and on leadership roles themselves. It is suggested that strategic change in these organizations requires collaborat ive leadership involving constellations of actors playing distinct but tightly-knit roles. Yet, collaborative leadership is fragile and can easily disintegrate due to intemal conflict or to discreditation associated with more unpopular (although potentially effective) change tactics. Thus, under ambiguity, radical trans formations may tend to occur in a cyclical non-linear pattern with periods of substantive change alternating with periods of political realignment. The paper concludes with a series of five propositions concerning the collaborative, cyc lical, interpretative, and entropic nature of leadership and strategic change pro cesses under ambiguity.