Dust in the wind? How leadership transitions unfold in purpose-oriented networks

BACKGROUND: Health care is increasingly organized in networks in which organizations collaborate to address health care's grand challenges. While leadership is key to network effectiveness but can be disrupted by turnovers, little is known about how leadership transitions unfold. PURPOSE: This study aimed to understand how such leadership transitions unfold in purpose-oriented networks. METHODOLOGY/APPROACH: We explored this through an in-depth case study of a network prior and during a leadership transition (5 years), performing 34 interviews, 46 hours of observations, and collecting documents. RESULTS: Our results show that an unexpected leadership transition can take time and affect dynamics such as trust and the network's composition. A lead organization can be established based on either its organizational characteristics or the characteristics of its individuals. In the latter case, the network's governance structure may be less stable. Covert conversations and decision-making occurred outside formal network meetings, showing that the influence of formal leaders, though lacking formal hierarchy, may be larger than previous research suggests. FINDINGS: Leadership transitions can affect dynamics in networks negatively and the influence of formal leaders, though they lack formal hierarchy, may be larger than previously suggested. Lead organization can emerge through different ways, including personal characteristics, organizational resources, and organizational-network goal alignment. PRACTICE IMPLICATIONS: Networks benefit from consciously designing their governance and leadership structure in a way that diminishes the effects of an unexpected transition, such as dual leadership from two organizations. Furthermore, networks should consider the three pathways for lead organizations to emerge in choosing their lead organization during each life-cycle phase.