Abstract
Abstract: A social network analysis of eighty-nine midlevel health care professionals showed that middle managers' strategic knowledge is positively associated with championing alternative ideas and synthesizing new information for upper management. In addition, the relationship between knowledge and middle management strategic activities in informal networks is moderated by the manager's social position.
The health care industry, often described as a high velocity environment1 or as part of a complex, adaptive system,2 demands special focus on strategic decision-making by management teams. To date, most research in this area has focused on upper management teams. Recently, however, researchers have suggested that the inclusion of a more diverse strategy-making team at multiple levels fosters the implementation of strategic decisions.3 At both upper and middle management levels, however, complex interactions among individuals that describe the decision-making process have been largely ignored. Thus, this study seeks to better understand how complex interactions drive the decision-making process by adopting a middle management perspective4 in conjunction with a social network approach.5
The primary goal of the study was to explain how middle managers' strategic knowledge and the prevailing social structure of the hospital interact to help facilitate organizational change. In effect, the study "unbundled" the socially complex nature of organizational change from a perspective that assumes the middle manager is strategically positioned at the confluence of critical information.