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ObjectivesThis study aimed at opening the black box of the relationship between leadership and motivation of health workers by focusing on a high-performance hospital in Morocco.DesignWe adopted the realist evaluation approach and used the case study design to test the initial programme theory we formulated on the basis of a scoping review on complex leadership. We used the Intervention-Context-Actors-Mechanism-Outcome Configuration as a heuristic tool to identify plausible causal configurations.SettingsSince 2000, the Ministry of Health in Morocco initiated many reforms in the frame of the governmental deconcentration process called ‘advanced regionalisation’. The implementation of these reforms is hampered by inadequate human resource management capacities of local health system managers. Yet, the National ‘Concours Qualité’, a national quality assurance programme implemented since 2007, demonstrated that there are many islands of excellence. We explore how leadership may play a role in explaining these islands of excellence.ParticipantsWe carried out a document review, 18 individual interviews and 3 group discussions (with doctors, administrators and nurses), and non-participant observations during a 2-week field visit in January–February 2018.ResultsWe confirmed that effective leaders adopt an appropriate mix of transactional, transformational and distributed leadership styles that fits the mission, goals, organisational culture and nature of tasks of the organisation and the individual characteristics of the personnel when organisational culture is conducive. Leadership effectiveness is conditioned by the degree of responsiveness to the basic psychological needs of autonomy, competence and relatedness, perceived organisational support and perceived supervisor support. Transactional and overcontrolling leadership behaviour decreased the satisfaction of the need for autonomy and mutual respect. By distributing leadership responsibilities, complex leaders create an enabling environment for collective efficacy and creative problem solving.ConclusionsWe found indications that in the Moroccan context, well-performing hospitals could be characterised by a good fit between leadership styles, organisational characteristics and individual staff attributes.

ObjectivesWe aimed at exploring the underlying mechanisms and contextual conditions by which leadership may influence ‘public service motivation’ of health providers in Moroccan hospitals.DesignWe used the realist evaluation (RE) approach in the following steps: eliciting the initial programme theory, designing the study, carrying out the data collection, doing the data analysis and synthesis. In practice, we adopted a multiple embedded case study design.SettingsWe used purposive sampling to select hospitals representing extreme cases displaying contrasting leadership practices and organisational performance scores using data from the Ministry of Health quality assurance programmes from 2011 to 2016.ParticipantsWe carried out, on average, 17 individual in-depth interviews in 4 hospitals as well as 7 focus group discussions and 8 group discussions with different cadres (administrators, nurses and doctors). We collected relevant documents (eg, performance audit, human resource availability) and carried out observations.ResultsComparing the Intervention-Context-Actor-Mechanism-Outcome configurations across the hospitals allowed us to confirm and refine our following programme theory: “Complex leaders, applying an appropriate mix of transactional, transformational and distributed leadership styles that fit organisational and individuals characteristics [I] can increase public service motivation, organisational commitment and extra role behaviours [O] by increasing perceived supervisor support and perceived organizational support and satisfying staff basic psychological needs [M], if the organisational culture is conducive and in the absence of perceived organisational politics [C]”.ConclusionsIn hospitals, the archetype of complex professional bureaucracies, leaders need to be able to balance between different leadership styles according to the staff’s profile, the nature of tasks and the organisational culture if they want to enhance public service motivation, intrinsic motivation and organisational commitment.

Diese Arbeit beschäftigt sich mit der Frage nach der Krisensicherheit aka Resilienz der österreichischen Organisationen, spezifisch der Organisationen innerhalb des öffentlichen Sektors. Es wird argumentiert, dass die Resilienz von Organisationen durch eine steigende Komplexität derer Umwelt immer mehr an Bedeutung gewinnt. Im Zuge dieser Überlegung werden zwei mögliche Einfussfaktoren organisationaler Resilienz diskutiert: Die Führung der jeweiligen Organisationen und Gender. Die Forschungsfragen lauten demnach „Wie wirkt sich in österreichischen Organisationen die Führung einer Organisation auf deren Resilienz aus?“, "Inwiefern unterscheiden sich Organisationen des öffentlichen Sektors von jenen im privaten Sektor in Hinblick auf deren Führung und Resilienz?“ und „Hängen Führung und Resilienz einer Organisation mit den Gender Rollen ihrer Mitarbeiter*innen zusammen?“. Eingebettet in die theoretischen Grundlagen der Systemtheorie und der Gendered Organization werden aus der bisherigen Forschung Hypothesen generiert, die im Anschluss mit Hilfe einer quantitativen Erhebung beantwortet wurden. Aus den Ergebnissen lassen sich beide Einflussfaktoren als solche bestätigen. Sowohl Führung als auch Gender Rollen haben einen Einfluss auf die Resilienz der beforsten Organisationen. Der öffentliche Sektor fällt sowohl in Sachen Führung als auch Resilienz leicht hinter dem privaten Sektor zurück. This thesis addresses the question of resilience within organizations in Austria. It argues, that organizational resilience becomes more important with the rising complexity of their environment or rather of the world. Following this assumption, two possible influencing factors of reorganizational resilience are discussed: Organizational leadership and gender roles. Accordingly, the research questions are as follows: „How does leadership in organizations in Austria influence their resilience?“, „In what capacity do organizations of the public and the private sector differ from one another in the aspect of their resilience?“ and „Are leadership or resilience linked to the gender roles of their employees?“. Imbedded in the theoretical surroundings of system theory and the theory of gender organizations, hypotheses are constructed, which are then tested using a quantitative poll. The findings confirm both factors as influences on organizational resilience in the polled organizations. The public sector is trailing the private sector in both leadership as well as resilience. Wien, FH Campus Wien, Masterarb., 2020

Background Nowadays, health systems are generally acknowledged to be complex social systems. Consequently, scholars, academics, practitioners, and policy-makers are exploring how to adopt a complexity perspective in health policy and system research. While leadership and complexity has been studied extensively outside health, the implications of complexity theories for the study of leadership in healthcare have received limited attention. We carried out a scoping review of complex leadership (CL) in healthcare to investigate how CL in healthcare has been defined, theorised and conceptualised and to explore how ‘CL’ has been applied in healthcare settings. Methods We followed the methodological steps proposed by (Arksey and O’Malley, 2005): (1) specifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating and summarizing the findings, and (6) reporting the results. We searched using Medline, Psychinfo, Wiley online library, and Google Scholar. Our inclusion criteria were: publication type (peer reviewed articles, theses, and book chapters); phenomenon of interest: complex leadership; context: healthcare and period of publication: between 2000 and 2016. Results Our search and selection resulted in 37 papers (16 conceptual papers, 14 empirical studies and 7 advocacy papers). We note that empirical studies on CL are few and almost all research reported by these papers was carried out in the North (mainly in USA and UK). We found that there is some variation in definitions of CL. Furthermore, the research papers adopt mostly an explorative or explanatory approach and do not focus on assessing effectiveness of CL approaches. Finally, we found that the majority of researchers seem to adhere to the mathematical complexity perspective. Conclusion Complexity concepts derived from natural sciences may not automatically fit management of health services. Further research into how social complexity theories may offer researchers useful grounds to empirically test CL theories in health settings is warranted. Specific attention should be paid to the multi-layered nature of leadership.

The research investigates the role of leadership in the transformation of denominational structures towards a missional ecclesiology, and focusses on the Highveld Synod of the Dutch Reformed Church. It describes the missional journey of the denomination, and interprets the transformation. The theory of ‘complex leadership’ in complex systems is applied to the investigation of the impact of leadership on a denominational structure. The theory identifies three mechanisms used by leaders as enablers in emergent, self-organisation systems: (1) Leaders disrupt existing patterns, (2) they encourage novelty, and (3) they act as sensemakers. These insights are applied as a tool to interpret the missional transformation of a denomination.

I organisationers begynnelse fanns en annan typ av verklighet mot den vi idag kan se. Dagens organisationssamhälle är starkt förändrat med en större globalisering och ett fragmenterat samhällsliv. Tillsammans med organisationers jakt på effektivisering och vinstmaximering skapas nya strukturer och former av organisering. Med dessa förändringar i organiseringen och organisationssamhället skapas även en ny verklighet för individer i VD-roller att verka i. Mer aktuellt än någonsin verkar också de många avhoppen och avskedanden av individer i denna roll vara. I min studie undersökte jag därför huruvida ansvar och krav på en VD är anpassade till dagens organisationssamhälle för att möjliggöra uppfyllandet av rollen. Denna frågeställning besvarar jag genom att studera vilka krav som ställs av omgivningen på individen i en VD-roll, hur individen i VD-rollen ser på sin roll och vad VD-rollen innebär i praktiken. Vad jag såg var att man i dagens organisering kan se en anpassning till den komplexitet som dagens organisationssamhälle innebär. Den ökade kunskaps-nivån i samhället och organisationerna som man kan se idag skapar en möjlighet till en ökad decentralisering som också medger en anpassning av ledarrollen. Jag såg dock en diskrepans i de krav som ställs av företagsstyrelsen på individerna i rollen mot hur de själva upplever innehållet i sin roll och där-igenom även sin person eftersom deras självidentitet påverkas till stor del av deras egenupplevelse av sin ledarroll. En diskrepans såg jag även mellan rollens praktik relaterat till både hur individen ser på sin roll samt hur omgivningen ställer krav på individen. Dessa delar anser jag bör ligga på företagsstyrelserna att arbeta med för att utforma sina krav anpassat till rollens praktik och individens egenupplevelse av rollen. Detta skulle kunna underlätta individernas möjlighet att uppfylla kraven på VD-rollen och lyckas i sitt arbete eftersom de idag har en mycket krävande arbetssituation med långa arbetsdagar och stora ansvar. In the beginning of organisations there was a different kind of reality to what we see today. Today´s organisational society is profoundly altered with a greater globalisation and a more fragmented society. Together with the strive for increased efficiency and profit maximisation by the organisations, this leads to new structures and organisational models. These changes in the organising and organisational society also create a new reality for the individuals in a CEO´s role to operate in. More topical than ever seem also the many defections and dismissals of individuals in this role to be. In my research I therefore studied whether responsibilities and requirements for a CEO are adapted to today´s organizational society to enable the fulfilment of the role. I reach the conclusion for this question by studying the requirements for the CEO role, the individual’s self-experience of the role and the practice of the CEO role. What I found was that an adaption to the complexity of today´s organizational society can be seen in today´s organisational models. The increased level of knowledge in society and organisations create an opportunity for greater decentralisation which also allows for an adjustment of the leadership role. I did, however, find a discrepancy in the demands made by the board of directors for the individuals in the role relative to their own self-experience of the role, and thereby also their persona as their self-identity is largely influenced by their self-experience of their leadership role. I also found a discrepancy between the practice of the role and the individuals self-experience of the role as well as the requirements made on the individual in the role. I consider these discrepancies to be the responsibility of the board of directors to ensure they are taken into account for when the requirements for the individuals in the role are defined. This could facilitate better possibilities for the individuals in the role to succeed as today´s reality includes a demanding working environment with long hours and great responsibility.

In today's knowledge-based economy, the sources of competitive advantage lie more and more in webs of relationships among a variety of firms that over time originate the emergence of interfirm strategic networks. The paper aims to shed light on the role of complex leadership exerted by network central firms in promoting and supporting network interactions and the ensuing processes of knowledge and resource transfer and diffusion. Processes on which the network-based sources of competitive advantage are rooted. In the attempt to make the proposed contribution, on the one hand, we underscore the emergent nature of network interactions stemming from the self-organizing behaviors that spontaneously arise inside the interfirm strategic network. On the other hand, we show that the leadership action of network central firms sparks off enabling effects that join to self- organizing network behaviors. The result of the two mentioned forces is an expansion of the network interaction potential that permits both the networked actors and the strategic network as a whole to reach level of performance that may not be accomplished otherwise.