Transformational change in a hospital: agency, structure, temporality and history in leadership

The paper sets out to build an understanding of how managers experience and navigate difficult organizational transition in the establishment of a new acute care department. Applying Bourdieu’s theoretical ideas and focusing on the intimate connection between political processes, historical conditions of the field and local attempts at change implementation, the study pays attention to power and agency in leadership. The study applies a longitudinal research design and focuses on the experiences of leaders in conducting their leadership in the context of field level change and development. The paper analyses leaders’ feelings of powerlessness as hysteresis that develops in a mismatch between field and habitus at a particular moment in time and demonstrates that leadership emerges and is made possible or impossible in relation to institutionalised capital and political objectives in the field. The study has important implication for the way in which we can understand leadership agency and the results may hold useful lessons for policy makers and leaders across private and public sectors.