Change agents

The use of agents to facilitate change in healthcare organisations is widely advocated. Organisational literature distinguishes between a variety of different types of agents (champions, opinion leaders and change agents), but we know little about how this distinction is implemented in practice and how different organisational members make sense of the role. Using sensemaking theories we study a case of large-scale organisational change and consider how senior managers, middle managers, and agents sensemake and enact change facilitating roles. We examine how this process determines successful organisational outcomes. We found that when new agent roles are accompanied by ambiguous managerial sensegiving, the accompanying sensemaking was dispersed and subsequently front-line role enactment was less effective. This suggests that for successful change senior management need to clearly distinguish the definitions and boundaries of this role.   

"Background: The use of agents to facilitate change in healthcare organisations is widely advocated. Organisational literature distinguishes between a variety of different types of agents (e.g. champions, opinion leaders and change agents), but we know little about how this distinction is implemented in practice and how different organisational members make sense of the role. Using sensemaking theories we study a case of large-scale organisational change and consider how senior managers, middle managers, and agents sensemake and enact change facilitating roles. We examine how this process determines successful organisational outcomes.
Methods: Data were collected from a case study analysis of significant organisational reconfiguration across a local National Health Service (NHS) Trust in the UK. Data consists of 82 interviews, complemented by analysis of over 100 documents and field notes from 36 hours of observations collected over five phases covering a three year period before, during and after the reconfiguration. An inductive qualitative analysis revealed the processes by which ambiguity in role definition developed.
Results: We found considerable differences in the perception of the change management roles from different organisational members leading to a dispersion of sensemaking about how the role should be enacted. We found that when new agent roles are accompanied by ambiguous managerial sensegiving, the accompanying sensemaking was dispersed and subsequently front-line role enactment was less effective.
Conclusion: This suggests that for successful change senior management need to clearly distinguish the definitions and boundaries of this role.   
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There has long been an assumption in the sensemaking literature that the development of interpretive schemes is an information gathering process.  In a study of the transition planning for a major hospital redevelopment programme in the UK we propose that the addition of social accounts theory to the frameworks of sensemaking and sensegiving helps us to understand how employees select messages for incorporation into a new interpretive scheme.  Absence of social accounts led employees to select alternative explanations for their role in facilitating the change. This was misaligned with the intentions of senior management. Instead managers need to provide social accounts that give explanations and provide reasons for their action, demonstrating how this information links with existing sensemaking.

This article draws together theoretical strands from cognitive science, psychoanalysis, and small group psychology in order to discuss theme repetition in organizations.  It suggests that attending to the possibility of theme repetition, even in apparently inconsequential interactions and small talk, can bring to light previously unnoticed connotations of policy or strategy.  This discussion leads on to a re examination and expansion of the notion of metapatterns.  These are tacit, emergent patterns of theme repetition in the meanings of organizational contexts.  Metapatterns may contribute to enculturation, culture formation, and the establishment of organizational stories, histories and artefacts.  They may also form a critical obstruction to organizational learning and change.  Consequences for researchers and consultants are investigated and it is proposed that, if metapatterns are to alter, recognition of a change agent’s own involvement in metapattern themes is required.

"Whilst the condition of a damaged ethical life has received due scholarly attention to date, only rarely is resistance to it conceived as an actual possibility with the potential of real effects on a macro-social scale. This is not just a curious lacuna in the literature. To ignore or miss concrete possibilities or even instances of resistance is to reinforce the apparent naturalness and inevitability of structures of injustice. The aim of this edited collection is to help address this epistemological neglect, exploring the multiplicity of motives, presuppositions, sites, ways, and consequences of acts of resistance. As shown in the ensuing contributions, resistance can be recalcitrant or transformative in its aims, discursive or physical in its means, and local or generalised in its loci. If there is a single argument that can be distilled, it is that the emergence of progressive resistance entails the incessant rational critique of so-styled ‘common sense’ and prevalent ethical claims–a process which could be called ‘the banality of good’. Contributors (in alphabetical order): Andrea Mubi Brighenti, Leonidas K. Cheliotis, Lilie Chouliaraki, Spiros Gangas, Richard Kearney, Alison Liebling, John O’Neill, Nancy Scheper-Hughes, Justice Tankebe, Ezra Tessler, Sappho Xenakis.


Contents

List of Contributors
Acknowledgements

1. Roots, Rites, and Sites of Resistance: The Banality of Good: An Introduction
Leonidas K. Cheliotis

2. Values, Crisis, and Resistance: Prospects for Freedom Reconsidered
Spiros Gangas

3. Narcissism, Humanism, and the Revolutionary Character in Erich Fromm’s Work
Leonidas K. Cheliotis

4. Thinking after Terror: An Interreligious Challenge
Richard Kearney

5. Ecce Homo: The Political Theology of Good and Evil
John O’Neill

6. Resistance as Transformation
Andrea Mubi Brighenti

7. Acting on Vulnerable Others: Ethical Agency in Media Discourse
Lilie Chouliaraki

8. Sites of Resistance: Death Row Homepages and the Politics of Compassion
Ezra Tessler

9. Face to Face with Abidoral Queiroz: Death Squads and Democracy in Northeast Brazil
Nancy Scheper-Hughes

10. Resisting Submission? The Obstinacy of ‘Balkan’ Characteristics in Greece as Dissidence against ‘The West’
Sappho Xenakis

11. Legitimation and Resistance: Police Reform in the (Un)Making
Justice Tankebe

12. ‘Governmentality’ and Governing Corrections: Do Senior Managers Resist?
Alison Liebling"

This study focuses on complex circumstances and defining characteristics of leading change as a middle manager. People in such roles are increasingly expected to lead organizational change as a normal part of their job. The paper draws on institutional theory and systems psychodynamic theory. The authors intend the resulting conceptual framework to increase understanding about the emotional and institutional challenges for middle managers as internal agents for change. Data gathered from 25 UK managers (representing 15 organizations) contribute substantially to this exploratory study. Three overarching issues emerged from an analysis of the data: (1) middle managers feel uncertain while having to show certainty about change; (2) leading change from the middle is prone to ambivalent authorization; and, (3) middle managers are expected to implement change without knowing how to intervene in the complex practical, emotional and political dynamics interwoven with attempts to lead change. The authors summarize two contributions to knowledge. Firstly, an understanding of collective emotions at work is shown to be important to middle managers’ potential effectiveness as internal change agents. Secondly, this pilot research begins a process of generating insights about some specific emotional and political dynamics that constrain and enable middle managers’ purposive action on leading change. From this apparent complexity, the authors derive questions about how both external and internal consultants prepare themselves and their clients to support managers in leading from the middle.