Nobody in charge: dispersed change agency in healthcare

Buchanan, David, Addicott, R., Fitzgerald, Louise, Ferlie, Ewan and Baeza, J. (2007) Nobody in charge: dispersed change agency in healthcare. Human Relations, 60 (7). pp. 1065-1090.


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.

Item Type: Article
Keywords: change agency; change management; distributed leadership healthcare; organizational change
Subject(s): Organisational behaviour
Date Deposited: 15 Aug 2013 13:16
Last Modified: 09 Sep 2016 13:47

Actions (login required)

Edit View Edit View