Who leads when the leader leaves: response to the absence of authority among Australian aged-health-care professionals

Damian Mitsch
Australian Graduate School of Entrepreneurship
Swinburne University of Technology
and
Neil E. Béchervaise
Australian Graduate School of Entrepreneurship
Swinburne University of Technology

Keywords: Health and Hospital Administration, Organizational Communication, Human Resource Management , Leadership, Identity, Teams, Boundaries, Unionisation, Communities of Practice, Organisational Culture, Transformational Leadership

Abstract

Australian Public Health (APH) was a state government entity responsible for public health care services in one geographic sector of a major Australian city through the 1990s. Together with several world-renowned research hospitals, APH was responsible for staffing, management and maintenance of aged, respite and after-care facilities. This paper draws, opportunistically, on the experience of a management change in two apparently similar aged care facilities, Boondah and Residon, to explore issues of leadership within bounded government institutions. It suggests that while clearly defined bureaucratic management may provide an active leadership model for individual and team behaviour within the professional service sector, identity and organisational culture become more substantial determinants of response to change in the absence of leadership. Pascale's (1999) approach to complex adaptive systems is identified as useful in describing team behavior in the absence of formal leadership though it is argued that time is seldom available for chaotic or unordered behavior to be resolved in the context of the operational quasi-governmental Nursing Home.

Background


The Nursing Homes

Situated in adjacent suburbs, Boondah and Residon are thirty bed Nursing Homes built on the same architectural plan with a similar resident mix, staffing levels, budgets and performance targets. Given these similarities, it seemed reasonable to expect that they would perform comparably in response to leadership change. However, "the modern business of management is often managing the 'insides' - the hopes, fears, and aspirations - of workers, rather than their behaviors directly" (Deetz, 1995, p. 87). As a result, when the managers of both Boondah and Residon retired amicably, almost simulaneously and independently of each other, they initiated an opportunity to examine the comparative impact of leadership change in a relatively constrained environment.

APH organisational structure

Australian Public Health was established to provide an organisational link between a duly elected, and therefore changeable, government responsible for the funding and management of public health and, the organisational units responsible for the provision of the State public health service. Its direct accountability to government necessitated a high level of control over its constituent service units and a significant level of governmentally palatable reporting procedures. At the time this study was undertaken, government was in transition, reporting demands were high and an element of party-political volatility could be anticipated among all stakeholders in public health provision.

The role of APH in this study, therefore, is viewed from two perspectives: as a government instrumentality bearing responsibility for initiating change at the level of individual health-care provision; and, as the funding source responsible for maintaining the quality and stability of provision. This ambiguity in expectation between change and stability, on the part of its various stakeholders assumes, however,

that control is achieved by designing and applying appropriate structures, procedures, measures and targets; and, relatedly, that resistance to these mechanisms is symptomatic of 'poor design' or 'poor management' that can be rectified by restructuring and/or training or staff replacement. (Alvesson + Willmott, 2001, p.4)

Identification of the stakeholders provides some light on the complexity of the APH charter.
 

• The government: required to provide a health care system to meet the needs of the State electorate
• APH personnel: required to meet the reporting needs of the government while minimising costs and electoral ferment
• Health care organisations: charged with delivery of quality health care with high public accountability at low cost
• Clients: frequently unable to assess the level of care provided
• Relatives of clients: personally emotionally involved, potentially overly critical, frequently politically 'noisy'
• Staff: including the APH appointed manager and ranging from professionally trained nursing staff to semi-skilled and unskilled support staff in service and administrative roles

As an administrative unit, APH can be seen as an hierarchical government administered organisation though this view "largely disregards or marginalises the issue of how control mechanisms are enacted by organizational members " (Weick, 1979).

The demonstrable yet undefined responsibility loops constraining the operation of the APH result, in some measure, from the multiple representation of individuals within the administrative hierarchy. At a pragmatic level, multiple representation is featured in the potential for multiple identity and the ambiguity of interests underpinning stakeholder representation. In consequence, a simple explication of the leadership demands and expectations of an organisation operating under APH governance become increasingly complicated because "identity regulation [remains] a significant, neglected and increasingly important modality of organizational control ... in the professional service sector." (Alvesson + Willmott, 2001, p.3)

Leadership change

Boondah and Residon were each subjected to a change in manager over a six-month period. This change was the result of two managers resigning on good terms with the organisation and leaving their positions vacant. The manager is expected to provide the leadership required to sustain performance in addition to managing the facility.

Boondah was first to have its manager leave. The position was filled by a temporary appointment specifically employed to manage the facility whilst a new manager was located. Some twelve weeks later, a structure was implemented that saw the manager of a nearby facility take on the role of managing two facilities. This manager brought with her the second in command from that facility.

Meanwhile, the manager of Residon also resigned. The opportunity to implement a structure similar to the Boondah solution was taken - two managers were given responsibility for four facilities. The nursing union movement was swift to condemn this solution as 'expedient' and 'opportunistic' because it created different structures to those common across the remainder of an industry considered to have 'cottage' status. As a complication to the industrial issues, a new State government with strong links to the nursing union was elected. The new political message demanded a return to the previous structure. The newly-appointed managers (including the second in charge at Boondah), returned to their original positions leaving Boondah and Residon leaderless again.

At this point, a quality candidate became available to manage the Residon facility. The new candidate had a clear understanding of what was required and was ready to take on the role. Boondah, in contrast, appointed an acting manager - who did not apply for the position when it was advertised.

In summary, Residon underwent a relatively swift transition from the initial managers' resignation to the appointment of a new permanent manager. Boondah, however, endured almost constantly changing management over six months. The performance of the two businesses reflected the uncertainty in the key management position of the facility. The effects of this uncertainty on staff, clients and performance varied substantially with some interesting results.

One of the important factors in this study was the number of constants that appeared to exist between the two organisations. The two facilities were identical in their built environment, remuneration and reward structures, and senior management structure. The client mix was similar and the workplace cultures exhibited many similar attributes. Whilst it is not possible to suggest that the two organisations were the same except for the changes in leadership, ability to view the effects of the changes was increased due to the level of apparent similarity between the two organisations. This allowed for an improved focus on the factors that differed between the facilities rather than on explaining away the impact of other factors that might have played a part in the differing performance levels.

Organisational Structure

Metaphorically, Australian Public Health can be identified, in Morgan's (1997) terms, as a mechanistic organisation. However, in considering the metaphor, it is important to recognize that the political necessity of managing risk to government is a substantial restriction when applied to the management of such government organisations (Borins, 2000). Within the megalithic machine that is APH, LaPorte (1996) suggests that policy is significantly created and managed in an incremental fashion to ensure continued public support - a significant influence in any government’s ability to pursue re-election. The result is that public organisations generally exhibit considerable attention to administration. In consequence of these identifiable features of the bureaucratisation of the organisation, APH may be defined, according to Adizes (1990), as a 'mature' or 'aged' organisation.

Australian Public Heath had a substantial range of well defined rules, procedures, plans and processes to ensure accountability and minimize risk to government. Within this construct, it was expected that the performance of any particular facility would remain stable. The widely differing levels of performance displayed at each facility in the absence of an appointed manager, however, suggest that performance relies on more complex factors than simply structure or rules.

The complexity within the organisations might be partly explained by considering the culture of the organisation and the way in which the members of this culture reacted to the shifting leadership. Morgan (1997) suggests a number of metaphors that may be used to examine the working of organisations. The metaphor of the mechanistic organisation clearly fails to explain the differing responses of Boondah and Residon. An appropriate number of cogs in each of the "machines" continued to work and the rules to follow were both clear and unchanged. The complex interrelationship between teams, individuals and clients, however, had been disrupted.

This paper focuses on a range of metaphors to illuminate the discussion around how culture, leadership, power, conflict and change impacted on two organisations that seemed, at first sight, to operate mechanistically.

Micro level structure

Focusing on the organisation at a micro level reveals elements of the mechanistic organisational structure within which a more organic unit survives. The APH rules, policies and procedures continue to exist but are applied to a lesser degree. At this micro level, the cultural aspects of the facility are seen to include a number of distinct groups or teams:

Complex teams Complex team structure with staff having a range of qualifications. Simple teams Several staff working in a team environment. Non-professional staff. Autonomous Staff Autonomous roles. Non-professional staff.

Each of these groups displays an interdependence with the other and with the manager of the individual facility. The managers played a significant role within the culture of the organisation, both in providing leadership and in the management functions of planning and controlling.

The group allocated role of the leader

The organisational culture in the subject facilities is strongly rooted in the notion of the team with a focus on care as the primary task (De Board ,1997). Socially constructed beliefs within this culture traditionally vest leadership in the role of the manager. This allocated role is then required to provide primary communication links between the facility and the external environment. Much like the figurehead of a family, the manager-as-leader seeks to inform, teach, and guide both teams and individuals to ensure the ongoing survival of the organisation. In addition, the figurehead seeks to protect the members from threats to the environment of the facility so that they can continue to focus on their primary task of care giving.

The culture and management within the Nursing Homes accepted and required that the manager interpret information from the macro organisation, the APH, and provide direction as a response to that information. This acceptance of management roles requires recognition that a significant amount of power can and should be derived from the boundary management between the micro and macro organisation. In addition, the manager is expected to ensure that levels of conflict and balance of power between groups within the facility remain at healthy levels.

Emergent Leadership and the psychic prison

While the relatively brief leadership hiatus at Residon was observed by several senior staff, the impact of disrupted leadership over 12 weeks became substantial at Boondah . Most evidently at Boondah, little naturally occurring leadership emerged. While this was barely noticed within simple work teams and among individuals, the more complex teams became fragmented in their response and unwilling to sustain approaches suggested as interim. In essence, the leadership was seen to be fragmented and in turmoil:

there is nobody really in charge. The day staff do things their way, the night girls do them a different way and there isn't anybody making sure that things are coordinated ... there isn't anybody to ask advice from that will be here in six months. (Marie Claire)

In providing a 'metaphor for all seasons', Gareth Morgan (1997) might suggest that Boondah had achieved the organisational leadership status of a psychic prison. Deprived of apparently disempowering leadership structures, staff milled about in the prison yard of their own perceptions. Members from whom leadership might have been anticipated sought leadership replacement from outside the immediate organisational structure through resort to professional Union action.

Morgan's psychic prison chillingly locates the social construction surrounding leadership within Boondah. The culturally accepted role of leader was vested in the manager's position in ways such that, if there was no manager then by definition there could be no leader. Staff had constructed highly bounded and simplified roles for themselves within otherwise complex teams. As nurses, domestic staff or administration assistants, they were unable to assume leadership without being externally and officially appointed from their existing role to the role of manager. When Janine, a senior nursing administrator within her team at Boondah, chose to put herself forward for the role of leader, she asked to be formally appointed as acting manager even though it appeared that she could have led the organisation without a formal appointment.

In fact, staff at each facility actively promoted the appointment of a person to the position of manager, reflecting a culture of dependence on the manager as leader. Each facility presented elements of dependence on the formal leadership structure.

The choice of person that the staff at Boondah promoted as being a suitable candidate provided further insight into the leadership processes within the facilities. DeBoard (1978) discusses the effects of failed leadership in situations of dependence and draws the conclusion that the group will choose leaders who are likely to maintain and protect group identity and stability. He similarly observes the mutual dependence between leadership and followership though he neglects the problematic situation where dependence is on leadership that is not available. In the case of Boondah, staff actively engaged in promoting the appointment of a leader who was familiar with the norms and beliefs of the workforce, a leader familiar with the organisational culture of the specific Nursing Home who would maintain the group’s 'psychic' reality.

Leadership, risk and conflict

While risk aversion is a principle of geriatric nursing, independence and initiative within complex teams is an integral determinant in assessing group effectiveness. In the absence of immediate managerial direction, complex teams are expected to meet and deal with emergencies. Group behaviour in the absence of an appointed manager at both Residon and Boondah, however, suggested a withdrawal from normal decision-making involving risk-taking.

We need to make decisions every day but without a manager to ask, I'm not going to stick my head up and have it cut off. All I'm going to do is keep things going until a new manager arrives. I know we need to meet accreditation but we aren’t really sure what needs to be done. We will wait and see what the other facilities do. (Marie Claire)

The team leader's resistance to making what under normal circumstances would be an acceptable decision, suggests that she had, albeit unconsciously, reduced the level of responsibility she was willing to accept. In effect, she had reduced the boundaries of her own responsibility to a point within her normally accepted capacity. In creating a buffer zone, a field of non-responsibility, Marie Claire and several of her colleagues redefined their boundary management roles to establish internally operational teams with little or no external responsibility for that operation.

Under normal management conditions, it could be expected that the team leader would apply information gained from her boundary management function to guide staff in levels of risk taking acceptable within the wider organisation. Staff at Boondah, however, withdrew from boundary management risk-taking in the absence of a manager. Further, they observed that the culture altered in the absence of a leadership figure as opposed to being stabilized by the power held by a leader within the role of manager.

Revolt of the relatives

Conflict management in the absence of an appointed leader was similarly constrained. Among the unique groups of followers in the leader / follower relationship at a Nursing Home are the residents' relatives. In the absence of a leadership figure within Boondah, reports of the relatives beginning to "take over" certain aspects of the facility increased. Relatives began to 'break the rules' and behavioral norms of the organisation. In the absence of a manager, normally capable and independent teams suddenly reported themselves ill-prepared to deal with the situations and the conflict that resulted. There had previously been a dependence on the leader to manage such conflict. In contrast, the disruption at Residon appears to have been minimal and it might be argued that the differences in approach to filling the leadership void were significant in generating this difference.

Though the residents' relatives moved to occupy an apparent void at Boondah, the breakdown in accepted cultural behaviors also led to conflict between various staff groups within the organisation, particularly within the complex teams.

the division two nurses and domestic staff are doing whatever they like. They don't appear to listen to the nursing staff because I guess they have never had to in the past... It's difficult trying to get the place to work smoothly when the different staff want to do things their own way. As for the union getting called in to the place, that was ridiculous. If the staff domestic want to know what's going on, they just need to ask. (Madhu)

The permanent manager finally appointed to Boondah reinforced this view, observing that the power relationship between staff had shifted substantially away from those who previously and formally held authority toward those who had influence. This created an atmosphere where performance lost apparent accountability and an increase in conflict generated through risk-aversive behavior severely impacted on team performance. Again, the cultural norms of the organisation depended on the manager to resolve such conflict and conflict thrived until competent management was appointed.

The atmosphere when I arrived was amazing. Good people had pulled their heads in and the vocal minority had picked up the reins in the name of the Union. Teams that had excellent performance ratings were barely functional. Back-biting was rampant ... (Anne)

Effects on particular staff groupings

Disruption to the leadership function affected the various groupings of staff in different ways. The effects on autonomous staff appeared minimal.

My work doesn't really change that much. I don't get involved much with the other staff and I just do my work. (Lena)

Each manager is different in the way they want things done but most of the work doesn't change much. I don't really get involved in what the other staff are doing because their work doesn't affect my work. (Slava)

Autonomous staff seemed able to adjust easily to a change in management. Their job description was stable and although each middle manager might have wished for tasks to be completed in different ways, the overall impact on their work, status, salary and job security was minimal. This group of staff indicated that the change of management did not affect them beyond the different abilities of managers to remain organized and structured.

Simple teams were affected to a greater degree than individually autonomous staff. It seemed that the introduction of more complex work requiring more complex structure, rosters and relationships demanded increased levels of management.

In the kitchen, things don't change much if there is different people in charge, we just do what we know needs to be do ... Jan (cook) is a bit pushy though, she thinks that we should be doing things her way but that's not the way we've always done things. (Maria)

The kitchen staff just do whatever they want and it doesn't affect them. We have to deal with the needs of the residents, doctors, relatives and the other nurses. We cant be expected to handle all of it on our own and to continue to provide quality care, it's just not possible. We are all doing our best and trying to work as a team but we need someone to help deal with all of the extras (issues, problems, accreditation). (Lena)

The diversity of needs within teams was greater than between autonomous workers and permitted scope for personal needs to interfere with the tacit team identity. By far the greatest impact was on the complex teams within the organisation. Complex teams in each of the facilities perceived a greater disruption in the progression of the facility:

I don't know how we are going to meet accreditation, we know we need to get it but we don't know what needs to be done. We're doing the things that need to be done on a daily basis but there's no education being run. People aren't attending meetings. We don't know what is going on with accreditation, the rosters are in a mess, we're using heaps of agency and no-one here is doing anything about it. There has been managers come and go but we need someone that's going to stick around to fix all these things. (Madhu)

Nursing staff in particular indicated that although they were a team and that day-to-day work continued in the main to be of a high standard, the progress of ongoing improvement, policy development and working toward accreditation was temporarily stalled.

Complex Adaptive Teams

Some behaviours observed in the nursing teams may be explained by using Wheatley's (1992) metaphor of the complex adaptive system - recognized as the result of lack of rigidity at the boundaries of a system - where, "in a complex adaptive system, agents respond to their environment by using internalised rule sets that drive action" (Plsek and Greenhalgh, 2001 pp 627). The overlay of complex adaptive systems theory on the various types of groupings provides some valuable insight into the effect of leadership on the groupings themselves.

Simple teams were made up of staff with responsibility for tasks of a less complex nature (eg janitorial and catering services). They were mostly comprised of people with minimal professional qualifications and their responsibilities could be completed with particular and expected outcomes over relatively short periods of time (within hours as apposed to days or months) thus reducing complexity. These teams observed well defined boundaries in terms of the scope and structure of their duties as a result of duty statements developed around award conditions. Mechanistic management models adequately explain the ongoing level of performance of these groups - even during an apparent absence of leadership.

We know we just come and we work together and the job doesn't change because of the change of manager. We don't even know if she is there most times because she is not our direct supervisor. (Agnetha -janitorial staff)

Autonomous staff displayed little need for reliance on internalised rule sets as most processes were clearly documented within the rules, policies and norms of the organisation. Staff comment, however, suggested the possiblility that interaction between simple teams and the disrupted complex teams was a cause for the perceived effects of loss of leadership within the organisation by simple teams.

It's more important that we can keep getting on with the nursing staff. When they change then we all have to make changes and that's not easy because who says it is right anyway. (Agnetha -janitorial staff)

Autonomous staff such as vehicle drivers and accounts clerks were observably subject to more complex tasks and systems than the simple teams though this complexity was usually limited to an area within their personal locus of control. Based on documented rules, autonomous staff were able to adapt their role to maintain function without relying on the formal leadership. Their autonomy also allowed them to avoid much of the political disputation that engulfed Boondah, in particular, when the Nursing Homes lacked formal management.

Accounts keep coming whether there is a manager or not. Hours have to be recorded and wages have to be paid. That's got nothing much to do with management most of the time. Unless there's a change in the award or something - then it may be important. (Jenn -Accounts)

Complex nursing teams were clearly the most affected by a loss of authorised leadership within the organisation. It might be expected that leadership would emerge from these teams, however, the acculturation of nurses may have prevented them from taking on leadership where they perceived that leaders require special skills not inherent in the wider nursing community. Wheatley (1992) introduced the notion that complex adaptive systems will seek to self organize from chaos. We found no evidence that this occurred within either facility. It may be that the result of a mechanistic approach to public health care has created complex systems that are slow to adapt to an altered environment or that chaos, despite the doom-saying of some staff in each of the facilities, never existed.

Clearly, however, without an appointed leader guiding the facility, complex teams were ill-equipped to adapt to the wide range of interactions and requirements. The result appeared to be a shift by teams toward risk-aversion, withdrawal and the mechanistic stabilisation of a relatively low-level group identity intent on self-preservation.

Boundary Management

One of the key roles of the Nursing Home leader is the management of the boundary between the micro and macro organisation. Complex teams in this study were most affected by the loss of previously undefined boundary management functions. Obholzer and Roberts (1998) suggest that leadership and management provide dual roles in monitoring and adjusting to continuously destabilising forces initiated from both the internal and external environments. Under this model, the leader is required to keep the organisation focused on the primary task whilst adjusting to the external environment.

In the absence of a leader at Boondah, the organisation lost its links with the external environment and increased its internal focus. It withdrew into a more tightly bounded identification with team rather than with the more organic culture of the Nursing Home. The effect on simple or autonomous teams was minimal because any change in policy or process was communicated in writing and was duly carried out. In the absence of communication, existing rules remained the order of the day. Complex teams perceived that they were affected by the loss of boundary management because they expected to be influenced by more complex changing legislative and nursing practices being imposed from the macro environment. This apparently amplified the sense of leadership loss for members of complex teams.

The loss of boundary management appears to have introduced a feeling of isolation for staff as a result of the loss of informal communication between the facility and the wider organisation. When formal communications were received during the leadership hiatus, the perceived meanings could differ widely based on the experiences surrounding the communication (Shelby 1998 pp 2). Both Boondah and Residon had access to formal communications through company email and intranet services and most critical information was disseminated through the organisation's email system. However, while it was recognized that formal communications were still received at the facility, the experience surrounding the communication now appeared to be different. Morgan presents the metaphor of the organisation as an organism and, in this case, emails did not seem to conjure the same feelings as personal statements from the manager in highlighting the interdependence between the organisation and its environment.

One of the environmental factors that impacted on these facilities was the necessity to meet government accreditation. Both facilities were required to lodge a comprehensive accreditation workbook by March of the current year or risk the loss of significant income. Whilst Residon, with continued access to leadership, remained focused on this key environmental demand, the complex teams at Boondah failed to recognize any real threat arising from the demand and came extremely close to missing their deadlines for submission.

Morgan's 'operational and strategic response' to the environment was not undertaken as a management function (Tyson 1989 pp 18). The constant change to adjust to the demands of the environment had stalled and the organisation had become 'overbounded'. Such a condition would eventually lead to poor organisational health (Hirschhorn 1997 pp 37). This condition affected the micro organisation but its effects diminished the ability of middle management to ensure the future of the business.

Morgan's 'organism' metaphor highlights the interrelationship between the organisation and its environment and substantiates the need for feedback to the macro organisation from the micro organisation as a subsystem (Morgan, 1997 pp 42). Middle management was not receiving feedback on the progress of the organisation and, in some cases, was creating anxiety as a result of a perceived lack of interest in the needs of staff. At one stage, this anxiety prompted the involvement of unions in assisting the feedback and communication flow to the macro organisation. The loss of feedback affected the macro organisation's ability to recognize the failing performance of complex teams. In contrast, simple and autonomous team performance was more easily recognized within the shortened time frame and the reduced complexity of ongoing performance measures.

Suddenly we only had to report to Madhu [middle manager]. There was no-one sitting up there judging what you had to do. I suppose that should have made life easier but it didn't. I think we sort of panicked instead. No boss to fix things. (Jenn)

The loss of boundary management increased anxiety amongst nursing staff in particular as they felt unprotected and guided in the levels of change required to meet environmental challenges. Nor did they understand the urgency of the threats faced. Evidence of this was presented in the suggestion that in some cases, some staff were seeking to undermine the efforts of teams to progress toward new government accreditation requirements.

Of course, Joanne had a field day. Call in the Union. Write to the local member [of parliament]. A real field day with a brand new government making toughen-up noises and an accreditation report to be completed or we lose our funding. (Maida)

Some actions, as would be expected, appeared to be aimed at minimizing change and thus reducing the anxieties normally associated with such change. In the State political climate of the study, however, some individuals were seen to be overtly party-political and self-seeking as they sought to satisfy the multiple allegiances identified by Weick (1979) in maintaining loosely coupled systems. In what appears to be a perverse response, the necessity of change in leadership seemed to create greater levels of anxiety than the threat of loss of income and jobs inherent in a failure to meet accreditation.

Given that the complex teams in this study were made up of professional nursing staff whose internalised rules must, to some degree, be based on their professional training and experience, it is interesting to note that they were unable to adapt to an environment requiring changes to the administrative rather than the Nursing approaches to care. This might suggest that methods for training professional nurses are fundamentally flawed but it is more likely to indicate that their experience within the mechanistic processes and culture of the public health system have left them feeling disempowered from adaptation to change.

In a culture where authorised leadership is responsible to government bureaucracy, the leader was required to buffer the staff from a harsh external environment and guide them through the change process in such a way that anxiety was kept down to a level that allowed the organisation to cope. Without that buffer, resistance to change was seen as the only way to maintain anxiety within acceptable limits.

When teams have different needs

Conway and Forrester (1999) propose that innovation can result from cross boundary interaction. Pragmatics, however, suggest that different teams with different functions may better be managed on a needs basis. Whilst the literature increasingly suggests that innovation and teamworking will generally be derived from cross boundary interactions, the leadership of Small to Medium sized organisations (SME) requires a capacity to recognize and adjust team development and management approaches to ensure a balance between capability, capacity and performance. In this respect, Pascale's (1999) interpretation of complex adaptive systems appears to suggest useful directions for the management of organisations.

Leaders, however, need to recognize the impact of existing policies, processes and structures on the future adaptability of complex teams within the organisation. The stability of existing organisational culture may require a pro-active approach in determining the extent to which management can or will allow team cultural definitions within an organisation before imposing a management structure contiguous with that of the parent organisation. There is little doubt that one of two outcomes could have occurred:

If middle management had maintained the status quo at Boondah without the appointment of a new senior manager, the organisation would have produced a leader or it would necessarily have died. The risk of death was too high to allow increasingly risk-aversive team cultural definitions to continue and a hasty but acceptable appointment was eventually made by APH to salvage the situation. (Arthur -Area coordinator for APH)

What does it all mean?

The issue of effective leadership styles has been debated widely in the literature though little consideration has been given to managing an organisation that is effectively leaderless. This case study presents some insight into dependence on leadership and its negative effects when that leadership is withdrawn. More importantly, it highlights the need for senior management to initiate and encourage appropriate levels of independence within complex teams to cope with the absence of authorised leadership.

The major conflict arising from confusion between management and leadership is frequently a battle for control. The quasi-independence of the Nursing home from its governmental parent corporation, suggests a highly ambiguous role for the CEO. On the one hand she is responsible to an external and politicised 'board' and a shareholding as diverse and disparate as the total community her Nursing Home serves. On the other hand, she is the boundary manager and immediate leader of a variously professional group of autonomous operatives, and simple and complex team players who seek her protection and guidance in the performance of identified duties of care to their largely invalid clients. Currrently, leadership must be undertaken within the context of the ability of mechanistic approaches to maximize output within certain types of work. However, it is argued that this approach weakens the potential of the organisation to operate effectively in the absence of an appointed leader.

At both Boondah and, to a lesser extent, Residon, there appears to have been a correlation between the complexity of the teams within the Nursing Home-as-SME and its ability to operate within the mechanistic framework of public sector management without a designated leadership figure. The cultures created at Boondah and Residon depended heavily on the leader to provide links between the environment, strategy, change and performance. In the process, there appears to have been a reinforcement of the psychic prison that prevented new leadership from emerging. The result was an overbounded closed system that, if left to its own devices, might not have survived the threat of environmental change. This dependence, while it has been identified as an artefact of previous management practices, nevertheless suggests that, for the Nursing Homes discussed in this study, management is about control, the power held by those in leadership and boundary regulating positions of power. The potential for extending rather than confining those boundaries in the absence of formal management has been the focus for this paper.

A fundamental flaw in the management models evident at Boondah and Residon arose from their failing to recognize that complex teams can be stifled by applying mechanistic models to the management of more organic types of sub-structures. Whilst the mechanistic model appears to have been appropriate to the culture of the nursing home and to have sustained the performance of simple teams, its outcome appears to have generated Morgan's 'psychic prisons'.

A more organic approach acknowledging the fundamentals of Pascale's (1999) complex adaptive systems might have allowed the complex teams to respond to change more rapidly and without anxiety increasing to levels that inhibited performance. The key challenge for management is how to apply multiple metaphorical approaches to an organisation threatened with chaotic or unordered behavior because of an absence of leadership in an effort to sustain performance during change.

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