Leading in Inter Organizational

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Matthias Mitterlechner
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Matthias Mitterlechner

Leading in
Inter-Organizational
Networks
Towards a
Reflexive Practice
Leading in Inter-Organizational Networks
 Matthias Mitterlechner

Leading in
Inter-Organizational
Networks
Towards a Reflexive Practice
Matthias Mitterlechner
University of St. Gallen
St. Gallen, Switzerland

ISBN 978-3-319-97978-6 ISBN 978-3-319-97979-3 (eBook)

https://doi.org/10.1007/978-3-319-97979-3

Library of Congress Control Number: 2018950496

© The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature
Switzerland AG 2019
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 Acknowledgements

This book results from a research project that started in September

2011. It would not have been possible without the invaluable contribu-
tions of many people.
The research center “Organization Studies” at the University of
St. Gallen has provided a uniquely collegial and inspiring context for
developing and writing this book. I particularly wish to thank Johannes
Rüegg-Stürm, who sparked my interest in organization studies many
years ago and who created ideal conditions for starting this project in
the first place. He has been a tremendous source of inspiration, a men-
tor, and a supporting friend all along my academic career. I am also
grateful for my collaboration with Harald Tuckermann, who has been
an insightful and caring colleague for many years. Furthermore, I would
like to thank the entire Organization Studies team for their continuous
support, fun, and intellectual inspiration at numerous seminars and
retreats in the Swiss mountains. I also wish to express my gratitude to
the Avina Foundation for trusting in this project and to the University
of St. Gallen for supporting my academic development with a faculty
position.

v
vi   Acknowledgements

Doing qualitative longitudinal research as reported in this book

builds on years of trusting relationships with partners in the field. I am
indebted to numerous executives, professionals, and politicians, who
provided me with unconstrained access to their everyday work and first-
hand insight into the challenge of working across organizational bound-
aries. I particularly thank Philipp Gunzinger, Joachim Koppenberg,
Claudia Farley, and David Fehr for their openness and ongoing trust in
our collaboration.
This book has benefited greatly from high-quality conversations with
scholars from around the world. Special thanks go to four international
reviewers and to the participants of the sub-theme “Practices of Inter-
Organizational Collaboration” at the 32nd Egos Colloquium in Naples,
who offered extremely helpful feedback to earlier versions of this book. I
also thank Liz Barlow, Madeleine Holder, and Gabriel Everington from
Palgrave Macmillan, who initiated and managed the publication process
with great dedication and care. Ellie Bradsher Schmidt patiently edited
the text and brought it into publishable language and shape.
Finally, writing this book was largely possible because of the uncon-
ditional support of my family members Andrea, Carina, and Lea Maria.
They granted me the freedom to pursue my passion for research includ-
ing countless days in the field and nights in the office. They are the joy
of my life, and my gratitude to them is boundless.

St. Gallen
August 2018
 Contents

1 The Need for Reflexive Leadership in Inter-Organizational

Networks 1
Research Question and Research Issues 3
Relevance to Research and Managerial Practice 5
Theoretical Perspectives 8
Empirical Perspectives 11
Contributions and Structure of the Book 14
References 19

2 Theoretical Foundations of Leadership in Networks 27

Action- and Structure-Oriented Theories of Leading in
Networks 28
Affordances and Limitations 33
Toward a Practice Theory of Leading in Networks 34
Summary and Outlook 37
References 38

vii
viii   Contents

3 Reconstructing Leadership in Networks as a Reflexive

Practice 43
Principles of Practice Theory 45
Networks as Bundles of Inter-Organizational Practices 52
The Practice of Leading in Inter-Organizational Networks 56
The Meaning and Role of Reflexivity in Leadership Practice 63
Summary and Outlook 69
References 70

4 Methodology 81
Longitudinal Qualitative Comparative Case Study Design 81
Research Context and Field Access 83
Data Collection and Analysis 89
Research Aim and Ethical Considerations 93
Summary and Outlook 95
References 95

5 A Practice-Theoretical Model of Reflexive Leadership

in Networks 99
Assumptions About Networks, Leadership, and the Role
of Reflexivity 99
A Closer Look at the Model 101
Summary and Outlook 104
References 105

6 Case Study I: Peripheral 109

Starting Conditions (2000–2002) 111
Period 1 (2003–2006): Peripheral’s Birth 119
Period 2 (2007–2008): Peripheral’s Pilot Phase 135
Period 3 (2009–2013): Integrating Care 150
Summary and Outlook 166

7 Case Study II: Urban 167

Starting Conditions (2000–2006) 169
Period 1 (2007–2009): Urban’s Launch 177
 Contents   ix

Period 2 (2010–2012): Building Urban 188

Period 3 (2013–2014): Ambulatory Primary Care 212
Summary and Outlook 228

8 Discussion 229
Comparative Analysis and Theorization 230
Theoretical Implications 261
Practical Implications 267
References 271

9 Conclusion 281
References 285

Appendix 1: Review of Literature on Leadership in Networks 287

Appendix 2: Additional Data from Peripheral 295

Appendix 3: Additional Data from Urban 301

Appendix 4: Data Sources Peripheral 309

Appendix 5: Data Sources Urban 311

Appendix 6: Questions for Reflexive Practitioners 313

References 315

Index 337
 List of Figures

Fig. 1.1 Argumentative structure of the book 17

Fig. 5.1 A practice-theoretical model of reflexive leadership
in networks 100
Fig. 6.1 A practice-theoretical model of reflexive leadership
in Peripheral 110
Fig. 6.2 Integration process as proposed by the third Care
Commission 127
Fig. 6.3 Peripheral’s governance structure as suggested
by the third Care Commission 128
Fig. 7.1 A practice-theoretical model of reflexive leadership
in Urban 168
Fig. 7.2 Structure of MHD as of 2006 172
Fig. 7.3 Organizational structure of Commission Urban 178
Fig. 7.4 Urban’s governance structure as of November 2009 182
Fig. 7.5 Division of roles and responsibilities among
TT, EC, and SC 192
Fig. 7.6 Attendance of leadership constellation members
in reflexive spaces 220
Fig. 8.1 Peripheral’s structure to reflect 237

xi
xii   List of Figures

Fig. 8.2 Urban’s structure to reflect 238

Fig. 8.3 Seven starting points for enabling reflexive conversations
in networks 240
Fig. 8.4 Peripheral’s virtuous leadership dynamics 257
Fig. 8.5 Urban’s vicious leadership dynamics 257
 List of Tables

Table 2.1 Action- and structure-oriented theories of leadership

in networks 29
Table 2.2 Practice-oriented theories of leadership in networks 35
Table 3.1 Principles of practice theory 45
Table 3.2 Theoretical traditions in network research 52
Table 3.3 Central ideas of the practice of leading in
inter-organizational networks 58
Table 3.4 Recent advances in conceptualizing reflexivity 65
Table 4.1 Theoretical sampling of comparative case study 85
Table 4.2 Sources of data collected between September 2011
and December 2015 90
Table 6.1 Organization-level structures (2000–2002) 113
Table 6.2 Leadership constellation members in period 1 123
Table 6.3 Peripheral’s hospital discharge working table 157
Table 7.1 Planned implementation projects as of 2006 174
Table 7.2 MHD implementation projects launched between
2007 and 2009 181
Table 7.3 Urban’s annual events calendar 192
Table 7.4 Reflections about Urban’s strategy in Executive
Committee meetings 193

xiii
xiv   List of Tables

Table 7.5 Reflections about Urban’s strategy in Think

Tank meetings 196
Table 7.6 Agendas of Urban’s General Meetings 200
Table 7.7 Agendas of Urban’s Annual Meetings 201
Table 7.8 Reflections about Ambulatory Primary Care 216
Table 8.1 Building blocks of a practice theory of reflexive leadership
in networks 231
 1
The Need for Reflexive Leadership
in Inter-Organizational Networks

Scholars have long recognized the growing importance and prevalence

of collaboration in inter-organizational networks that consist of three
or more partner organizations (Huxham, 2003; Huxham & Vangen,
2000b; Müller-Seitz & Sydow, 2012; Sydow & Windeler, 1998).
Strategy researchers argue that organizations engage in inter-organi-
zational networks (networks, for short) to secure competitive advan-
tage (Dyer & Singh, 1998). They also contend that today’s competition
increasingly takes place among blocks of allied firms rather than among
single, isolated companies (Gomes-Casseres, 1996; Vanhaverbeke &
Noorderhaven, 2001).
Public policy experts additionally submit that networks composed
of a variety of government, nonprofit, and business organizations are
essential for tackling collective action problems, such as integrated
health, migration, environmental protection, or poverty alleviation
(Kenis & Provan, 2006). Solutions for these issues necessarily “sit
within the inter-organizational domain” (Huxham & Vangen, 2000b,
p. 1159) and can be addressed effectively only if several organizations
collaborate. Many governments around the world therefore seek to
improve their effectiveness and efficiency by transforming the structures

© The Author(s) 2019 1

M. Mitterlechner, Leading in Inter-Organizational Networks,
https://doi.org/10.1007/978-3-319-97979-3_1
2   M. Mitterlechner

of their service delivery from hierarchies and markets toward networks

(Crosby & Bryson, 2010; Currie, Grubnic, & Hodges, 2011; Currie,
Lockett, & Suhomlinova, 2009; Huxham & Vangen, 2000b; Kenis
& Provan, 2006; Kickert, Klijn, & Koppenjan, 1997).
In view of the rising importance and prevalence of network-based
collaboration both within and across the private and public sector, it is
quite astonishing how little we know about how member organizations
actually practice leadership in the networks in which they are engaged.
Huxham and Vangen (2000b) notice that with few notable exceptions
“the literature on collaboration—including that on private sector alli-
ances—has had little to say about leadership. Some texts make passing
reference to leaders, but the concept is rarely discussed in detail” (p.
1160). In a similar vein, Crosby and Bryson (2010) observe that “lead-
ership language and scholarship have been remarkably scarce in the aca-
demic literature on collaboration” (p. 212).
One reason may be that previous research has focused on leadership
between people, in groups or within organizations, neglecting more
complex inter-organizational contexts such as supply networks, pub-
lic–private partnerships, regional clusters, and other inter-organizational
innovation systems (Sydow, Lerch, Huxham, & Hibbert, 2011).
Regardless of the causes, there seems to be a growing need for
advancing research and theory on the practice of leadership in inter-
organizational networks. Leadership is understood here as the exertion
of influence in order to make things happen, often despite a lack of for-
mal authority (Huxham, 2000; Huxham & Vangen, 2000b; Müller-
Seitz & Sydow, 2012). Leadership is widely seen as a critical ingredient
for effective collaboration in networks (e.g., Bryson, Crosby, & Stone,
2015; Chrislip & Larson, 1994; Crosby & Bryson, 2005; Huxham &
Vangen, 2000b, 2005; Müller-Seitz, 2012; Müller-Seitz & Sydow, 2012;
Provan, Fish, & Sydow, 2007; Vangen & Huxham, 2003). Crosby and
Bryson (2010) argue that “leadership work is central to the creation and
maintenance of cross-sector collaborations that advance the common
good” (p. 212). Provan et al. (2007) suggest that “it is imperative that
network researchers understand how whole networks operate, how they
might best be structured and managed, and what outcomes might result.
At present, network researchers in business, public management, and
 1 The Need for Reflexive Leadership in Inter-Organizational …    
3

health care services have only a marginal understanding of whole net-

works, despite their importance as a macro-level social issue. Enhancing
this knowledge is clearly a challenge that researchers in all sectors must
take seriously” (p. 512). Sydow, Schüssler, and Müller-Seitz (2016) sim-
ilarly contend that forming networks is not only a strategic but also a
leadership issue, calling for reflexivity in the leadership of networks.
This book reports on a study designed to address this challenge and
meet the need and opportunity for more theory in this area. It aims at
theoretically conceptualizing and empirically describing the practice of
reflexive leadership in the context of networks.

Research Question and Research Issues

This study explores the following research question: How do mem-
ber organizations practice leadership in a reflexive way in the networks
in which they are involved? This research question entails five research
issues.
First, there is a need to adopt a dynamic view on leading in networks.
Theory building on networks has mainly focused cross-sectional anal-
yses (Ahuja, Soda, & Zaheer, 2012; Bizzi & Langley, 2012; Lorenzoni
& Lipparini, 1999). Although longitudinal research has become more
common in recent years, we still know very little about the dynamics
of leading in networks. As Clegg, Josserand, Mehra, and Pitsis (2016)
note, “the question of the management of network dynamics, while
crucial, remains under-researched” (p. 281). Provan and Kenis (2008)
therefore argue for more systematic research on how leadership in net-
works emerges and changes over time. Lorenzoni and Lipparini (1999)
similarly suggest that there is “still a strong need for better theories on
network evolution and change” (p. 318).
Second, there is a need to study the interplay between leadership
practice and network effectiveness. Raab and Kenis (2009) argue that
scholars need to develop network theories that are able to explain
the emergence, functioning, effectiveness, and failure of networks.
Regarding leadership practice, they suggest explaining network effec-
tiveness by observing the actions of individual actors, which are based
4   M. Mitterlechner

on the cultural norms of the professions and the sectors in which these
actors are embedded. In a similar vein, Provan et al. (2007) argue for a
closer analysis of network effectiveness. “If we are to understand about
networks and network performance, then it is essential that network
effectiveness be addressed” (p. 509).
Third, there is a need to study leadership in networks from multiple
analytical levels. Relevant analytical levels span the societal, field, net-
work, organizational, group, and individual level (Sydow & Duschek,
2011). It has been suggested that leadership in networks should be
studied at least from the network and the two neighboring levels, i.e.,
the organizational field and the organization level. “At the same time,
it is clear that at a more micro level, organizations should be brought
back into network-level research to investigate, for example, how, on
the one hand, organizations are affected by their engagement in differ-
ent types of networks and how, on the other hand, organizations get
ready for networking. On a more macro-level, the more or less recursive
interplay between whole networks and regional clusters, organizational
fields, or complete societies should also be put on the agenda of net-
work researchers” (Provan et al., 2007, pp. 511–512). At present, mul-
ti-level theorizing has remained scarce in network research (Sydow et al.,
2016). This lack of multi-level research provides one explanation for our
still poor understanding of the temporal evolution of networks. “The
fact that the development of networks has remained poorly understood
is due to a lack of research on the co-evolution of network, network
environment, and network organizations” (Sydow & Duschek, 2011,
p. 203, my translation).
Fourth, there is a need to study leadership in heterarchical networks.
A recent literature review (Müller-Seitz, 2012) reveals that the few stud-
ies that do exist on leadership in networks tend to focus on leadership
in hierarchical networks. In hierarchical networks, a single organization
(sometimes called a “hub firm,” “strategic center,” or “network orches-
trator”) officially presides over a network and exerts, at least in part,
formally legitimated leadership. Heterarchical networks, by contrast,
consist of more or less equal partners that do not formally dispose of a
leading actor (Müller-Seitz & Sydow, 2012). In heterarchical networks,
leadership tends to be more dispersed and temporary, and activities and
 1 The Need for Reflexive Leadership in Inter-Organizational …    
5

decisions are frequently based upon consensus across network partners

(Sydow et al., 2016). In these networks, leadership-exerting organiza-
tions only have the capacity to set some boundary conditions but might
not be able to exert strong influence on their networks due to a lack
of formal authority (Müller-Seitz, 2012). Müller-Seitz (2012) points
out that the study of leadership in heterarchical networks is closely
connected to the first research issue, i.e., the need to adopt a dynamic
perspective on leadership. “Because the organization responsible for
the exertion of leadership in heterarchical networks can vary over time
because of conflicting outcomes from consensus-based decision-making
processes (Huxham, 2000; Provan & Kenis, 2008), longitudinal and
more process-oriented studies are likely to be more suitable for under-
standing leadership in heterarchical networks” (p. 439).
Fifth, there is a rising need for reflexivity (Cunliffe, 2004; Cunliffe &
Easterby-Smith, 2004) in the leadership of networks. Huxham (2000)
has long argued that those who take leadership roles in networks need
to be serious reflexive practitioners. Sydow et al. (2016) make a simi-
lar call for reflexivity in leading and managing networks, arguing for
an institutionalization of reflexivity in organizations in general and in
networks in particular. At the moment, however, we know little about
how reflexivity can be institutionalized in the leadership of networks.
Research is largely still concerned with the collection of questions and
problems rather than with the creation of satisfying answers (Sydow &
Duschek, 2011).

Relevance to Research and Managerial Practice

A more detailed theoretical conceptualization and empirical descrip-
tion of the practice of reflexive leadership in networks is highly relevant
because it relates to emerging issues in at least three research fields and
is of considerable importance for managerial practice.
First and foremost, as indicated previously, the practice of reflexive
leadership turns into an increasingly relevant field of study for net-
work scholars (Müller-Seitz & Sydow, 2012; Sydow, 2004; Sydow et al.,
2016; Sydow & Windeler, 1998, 2003). Nosella and Petroni (2007)
6   M. Mitterlechner

emphasize that leadership in networks is an extremely interesting topic

that has been dealt with very little in the literature. They therefore pro-
pose that “further research could study this topic more thoroughly and,
more generally, study the different ways networks, especially multilat-
eral networks, are managed” (p. 198). Provan and Kenis (2008) equally
propose that the role of leadership in networks needs to be addressed in
greater depth. They argue that a closer investigation of leadership is cru-
cial because only then can we understand why networks produce certain
outcomes—including the poor performance of some of them.
Second, exploring reflexive leadership in networks resonates with
recent advances and emerging questions in the broader leadership lit-
erature, in particular in the emerging leadership-as-practice field (e.g.,
Denis, Lamothe, & Langley, 2001; Denis, Langley, & Rouleau, 2005,
2010; Denis, Langley, & Sergi, 2012; Raelin, 2016). Leadership-as-
practice scholars draw from social theories of practice (Bourdieu, 1990;
Giddens, 1984; Reckwitz, 2002; Schatzki, 2002, 2012; Schatzki, Knorr
Cetina, & Von Savigny, 2001) and make the argument that leadership
occurs as a social, collective practice, as opposed to residing in the traits
and behavior of particular leader-individuals. They thereby question
and reconstruct one of the most fundamental assumptions of tradi-
tional leadership studies. They aim to increase the relevance and mean-
ingfulness of leadership research by focusing on the “mundane aspects
of managerial work and leadership” (Alvesson & Sveningsson, 2003,
p. 1436), deeply probing into everyday leadership practice (Knights
& Willmott, 1992). Researchers in this field are particularly interested
in developing an understanding of how leadership can be conceptual-
ized and studied when organizations are considered as practices rather
than static entities (Crevani, Lindgren, & Packendorff, 2010).
Third, the aim of this study is connected to emerging questions in
the debate on reflexivity in leadership practice (e.g., Boud, Cressey, &
Docherty, 2006; Cunliffe, 2004; Cunliffe & Easterby-Smith, 2004;
Cunliffe & Jun, 2005; Gorli, Nicolini, & Scaratti, 2015; Nicolini, Sher,
Childerstone, & Gorli, 2004; Reynolds & Vince, 2004; Rüegg-Stürm
& Grand, 2015). This debate has gained substantial momentum since
the turn of the millennium. With regard to the public sector, Cunliffe
and Jun (2005) argue for instance that reflexive leadership is crucial to
 1 The Need for Reflexive Leadership in Inter-Organizational …    
7

public administration because it can lead to more critical and responsi-

ble action, which, in turn, can provide a basis for organizational trans-
formation. Similarly, Boud et al. (2006) propose that the growing need
for reflexive leadership practice is constituted by structural changes in
the production regime from stable markets and physical mass products
toward volatile, flexible, and knowledge-intensive markets, products,
and services. They argue that this latter regime requires new forms of
responsiveness, learning, and reflexivity at work. While the growing
importance and significance of reflexive leadership practice is well estab-
lished, empirical studies are still rare in this nascent field. Researchers
have therefore called for more empirical studies that shed light on
how leadership is practiced in a reflexive way (Antonacopoulou, 2004;
Cotter & Cullen, 2012; Cunliffe & Easterby-Smith, 2004).
Finally, a robust theoretical conceptualization and thick empirical
description of reflexive leadership in networks is also of considerable
relevance for managerial practice. As Silvia and McGuire (2010) point
out, “just as organizations require some degree of leadership to function
effectively, so too do collaborative, integrated structures require leader-
ship that facilitates productive interaction and moves the parts toward
effective resolution of a problem” (p. 265). There are, however, substan-
tial limitations with regard to the transfer of knowledge and insights
from single organizations to networks because leadership in networks
is likely to be significantly different from leadership in organizations
(Huxham & Vangen, 2000b; Müller-Seitz, 2012; Provan & Lemaire,
2012). Networks are unique forms of organizing—neither markets nor
hierarchies (Powell, 1990)—that need to be analyzed and understood
in their own right (Kenis & Provan, 2006). In contrast to traditional
organizations, networks cannot be led by hierarchical fiat (Podolny &
Page, 1998). In networks, reflexive leadership turns into a joint effort
(Huxham & Vangen, 2000b) that needs to be collectively accom-
plished by a constellation of distributed, legally autonomous organiza-
tions (Beyer & Browning, 1999). In view of the ubiquity of networks
in both the public sector and private sector, practitioners will need to
become increasingly sophisticated in their understanding of the leader-
ship practices required for effectively accomplishing this task (Huxham
& Vangen, 2000b; McGuire & Silvia, 2009; Silvia & McGuire, 2010).
8   M. Mitterlechner

Theoretical Perspectives
To develop a theoretical conceptualization of the practice of reflexive
leadership in networks, this book draws on advances in four research
fields.
First, this research is situated in the recent practice-turn in the social
sciences (Feldman & Orlikowski, 2011; Feldman & Worline, 2016;
Giddens, 1984; Nicolini, 2012; Reckwitz, 2002; Schatzki et al., 2001).
In essence, practice theory proposes a distinct social ontology, conceiv-
ing of the social as “a field of embodied, materially interwoven practices
centrally organized around shared practical understandings” (Schatzki,
2001, p. 3). It thereby differs from other social theories, which privilege
individual action or social structure in defining the social (Reckwitz,
2002; Schatzki, 2001). Practice theory, with a focus on structuration
theory (Giddens, 1984), will provide the main organizing framework of
this research.
Second, network scholars are increasingly interested in conceiving
reflexive leadership in networks from a practice-theoretical perspec-
tive (e.g., Araujo & Brito, 1998; Huxham, 2003; Huxham & Vangen,
2000b; Martin, Currie, & Finn, 2008; Müller-Seitz & Sydow, 2012;
Sydow, 2005; Sydow et al., 2011, 2016; Sydow & Windeler, 1997,
1998). Drawing on Giddens’ (1984) structuration theory, Sydow and
Windeler (1998) argue, for instance, that an adequate analysis of lead-
ership in networks requires an exploration of how leadership action
and leadership structure are mutually related. Scholars adopting this
view suggest that practice theory offers a potentially promising alterna-
tive to traditional action- and structure-oriented notions of leadership
in networks for at least two reasons. On the one hand, practice theory
is best placed to provide a dynamic account of leadership in networks
and thereby to increase the practical relevance of research on this topic.
On the other hand, practice theory is able to conceptualize the inter-
play between action and structure as a duality rather than as a dualism.
To develop this argument in more depth, Chapter 2 will provide an
overview of extant research on leadership in networks. In a first step, it
will review a selection of established research, which tends to emphasize
 1 The Need for Reflexive Leadership in Inter-Organizational …    
9

either action or structure when theorizing leadership in networks. In a

second step, it will shed light on some of the affordances and limitations
of this line of research. In a third step, it will review studies that call
for advanced practice theories on reflexive leadership in networks. These
studies submit that practice theories are able to capture the recursive
interplay between action and structure over time.
Third, leadership scholars are increasingly interested in conceptualiz-
ing leadership from a practice-theoretical perspective. They assume that
leadership occurs as a practice rather than from the traits or actions of
individuals (Denis, Kisfalvi, Langley, & Rouleau, 2011; Denis et al.,
2001, 2005, 2010; Raelin, 2016). The emerging leadership-as-practice
perspective thereby offers a potentially valuable theoretical alternative to
individualistic notions of leadership in complex and pluralistic contexts
such as networks (Denis et al., 2005, 2010; Denis, Langley, & Rouleau,
2007; Huxham & Vangen, 2000a; Vangen & Huxham, 2003).
Pulling together recent ideas from practice, network, and leadership
scholars, Chapter 3 will develop theoretical foundations for conceptu-
alizing leadership in networks from a practice-theoretical perspective. It
will proceed in four steps. In a first step, it will review key principles
of practice theory with a special focus on Giddens’ (1984) structura-
tion theory (Feldman & Orlikowski, 2011; Feldman & Worline, 2016;
Giddens, 1984; Nicolini, 2012; Reckwitz, 2002; Schatzki et al., 2001).
In a second step, it will review contemporary definitions of the term
“network” and suggest adopting a view of a network as a social system
in which the activities of at least three legally independent organizations
are coordinated in time-space (Müller-Seitz & Sydow, 2012). From a
practice-theoretical perspective, a network can thus be understood as
formed by a bundle of inter-organizational practices, which are practices
that transcend the boundaries of individual organizations (Müller-Seitz
& Sydow, 2012; Sydow, Van Well, & Windeler, 1997). In a third step,
it will review latest insights into leadership in networks and suggest a
view of leading in networks as the exertion of influence by a single or
several organizations in order to reflexively coordinate the activities in
the network (Müller-Seitz & Sydow, 2012; Sydow & Windeler, 1998).
In a final step, in view of the reflexive nature of leading in networks, it
10   M. Mitterlechner

will clarify the meaning of the term “reflexivity,” which leads to the final
relevant research field.
Fourth, reflexivity scholars are increasingly interested in studying the
role of reflexivity in leadership practice (Boud et al., 2006; Cunliffe,
2004; Cunliffe & Easterby-Smith, 2004; Cunliffe & Jun, 2005; Gorli
et al., 2015; Nicolini et al., 2004; Reynolds & Vince, 2004a). Building
on Dewey’s (1910) early ideas about learning through reflective expe-
rience and Schon’s (1983) theory of the reflective practitioner, these
scholars have advanced the meaning of the notion of “reflexivity” into
three directions. First of all, they have drawn a distinction between
“reflection” and “reflexivity” (Cunliffe, 2004; Cunliffe & Easterby-
Smith, 2004; Cunliffe & Jun, 2005). The notion of “reflection” is
rooted in an objectivist ontology and describes an analytical process
in which an individual actor constructs a “mirror” image in order to
solve an objectively given problem. By contrast, the term “reflexivity”
builds on a social-constructionist ontology and suggests a view of reflex-
ivity as a conversational practice through which actors question tradi-
tional practices and explore new possibilities for joint action (Cunliffe
& Easterby-Smith, 2004; Cunliffe & Jun, 2005). In addition, and
related to the previous point, they have proposed that reflexivity is a
collective rather than an individual accomplishment (Boud et al., 2006;
Raelin, 2001; Reynolds & Vince, 2004a). Reflexivity is not the isolated
act of an individual but occurs in the midst of practice and is shared
in the presence of others. Finally, reflexivity scholars have recently
argued that reflexivity is not an objective and value-neutral practice as
implied by a realist ontology, but situated in socio-political structures
(Antonacopoulou, 2004; Cunliffe & Easterby-Smith, 2004; Nicolini
et al., 2004). Reflexive practice is enabled and constrained by these
socio-political structures and recursively changes them over time.
Taken together, Chapters 2 and 3 provide the theoretical background
of this book. While Chapter 2 sheds light on traditional theoretical
ideas about leading in networks, Chapter 3 provides important concep-
tual sensitizing devices for theorizing leadership in networks as a reflex-
ive practice.
 1 The Need for Reflexive Leadership in Inter-Organizational …    
11

Empirical Perspectives
To empirically describe the practice of reflexive leadership in networks,
I conducted a longitudinal, qualitative comparative case study in the
Swiss healthcare sector.
I conducted a qualitative comparative case study because qualitative
cases are particularly useful for studying “how” and “why” questions in
unexplored fields (Eisenhardt & Graebner, 2007). Both criteria applied
in this research. As mentioned before, research on leadership in net-
works has generally remained scant. In addition, we currently lack an
in-depth empirical understanding of how leadership in networks is prac-
ticed and why it produces certain outcomes. Moreover, I conducted a
comparative case study because comparative cases are typically consid-
ered as more compelling and robust (Yin, 2014).
I conducted the case study in the Swiss healthcare sector. Health care
is a particularly well-suited context for studying leadership in networks
because policy makers and organizational leaders around the world cur-
rently strive to improve the delivery of healthcare services by means of
better inter-organizational collaboration. Practitioners and research-
ers suggest that more coordination among provider organizations is
required to adapt a highly fragmented healthcare system to population
aging, increasing frailty at old age and a rapid rise in the number of peo-
ple with multiple health and care needs (e.g., Amelung, Hildebrandt,
& Wolf, 2012; Goodwin, Sonola, Thiel, & Kodner, 2013; Kodner &
Spreeuwenberg, 2002; Nolte et al., 2016). Leadership is found to be a
critical success factor for implementing these new integrated care and
population health models (e.g., Ling, Brereteon, Conklin, Newbould,
& Roland, 2012; Nolte et al., 2016).
In view of current ambitions to transform health care toward more
inter-organizational coordination and the critical role of leadership
in this context, I conducted the case study in collaboration with two
healthcare networks in Switzerland, “Peripheral” and “Urban.”1

1Inorder to protect the identity of my research partners, I will use pseudonyms throughout the
book.
12   M. Mitterlechner

Peripheral was located in a rural region secluded by mountains at the

Swiss border. The most important network members were the regional
hospital, an outpatient care organization, an inpatient care home, a
thermal spa, and several regional social services organizations. Due to its
effectiveness, it was considered as a pioneer network in Switzerland.
Urban was located in one of the major cities in Switzerland. It
included the most important healthcare provider organizations in the
city—among others the municipal health department, the municipal
pharmacy association, general practitioners, health insurance compa-
nies, an ethics foundation, social services organizations, nurses, three
hospitals, an outpatient care organization, and an education foundation.
Similar to Peripheral, the Swiss public considered Urban as one of the
most promising initiatives to advance integrated care in Switzerland.
Over time, however, it lost some of its initial momentum due to var-
ious difficulties, which will be empirically described and theoretically
explained in this book.
Reporting on these two case studies, this book generates several
findings.
First, it shows that individual network member organizations are
unable to reflexively coordinate network activities on their own. Rather,
leadership in networks is accomplished by a constellation of co-leaders
(e.g., Denis et al., 2010). The leadership constellation typically con-
sists of delegates from member organizations, but at times, it may also
include delegates from the organizational field level, for example, rep-
resentatives from political authorities. Leading in networks is hence a
collective, multi-level, and widely distributed undertaking (Huxham &
Vangen, 2000b; Sydow et al., 1997).
Second, leadership constellations reflexively coordinate network
activities by establishing reflexive spaces. Reflexive spaces are episodic
communicative events that involve several actors who are colocated in
the same physical or virtual space (Bucher & Langley, 2016; Hendry
& Seidl, 2003; Seidl & Guerard, 2015). In everyday life, these actors
are physically distributed across the various organizations constituting
a network. Reflexive spaces separate these actors from their everyday
practice and thereby provide them with a communicative occasion for
 1 The Need for Reflexive Leadership in Inter-Organizational …    
13

jointly reflecting on mutual dependencies and new ways of coordinating

practices across organizational boundaries.
Third, leadership constellations reflexively coordinate network activ-
ities by enabling reflexive conversations. Practical reflexivity about the
coordination of activities across organizational boundaries is a conver-
sational accomplishment (Cunliffe & Easterby-Smith, 2004; Cunliffe
& Jun, 2005). The two case studies provide a few clues about how
leadership constellations enable reflexive conversations. Leadership
constellations may enhance the reflexive quality of conversations by cre-
ating transparency about decision-relevant information; by allowing for
improvisation and experimentation; by deploying visual mapping tools;
by building personal ties; by showing understanding for differences; by
providing solution-oriented support; and by wisely orchestrating reflex-
ive spaces.
Fourth, leadership constellations reflexively coordinate network
activities by exercising power. In structuration theory, power is a means
for getting things done and as such, directly implied in human action
(Giddens, 1984). In networks, however, in which member organizations
lack formal hierarchical fiat, powerful interventions need to be consid-
ered as useful and legitimate (Müller-Seitz & Sydow, 2012). The find-
ings reported in this book suggest that meaningfulness and legitimacy
are sustained by consensual decision-making and communication on
“equal footing.” By contrast, dominant interventions from one network
member, despite best intentions, can create unintended consequences.
They may not only trigger questions about their usefulness and legiti-
macy, but also induce other network members to assume a passive role
in their network, which may eventually frustrate the reflexive coordina-
tion of network activities.
Finally, leadership constellations do not act in a vacuum. Their reflex-
ive actions are situated in structural properties at the organization, net-
work, and organizational field level. Over time, the recursive interplay
between reflexive leadership action and structural properties at these
three levels creates virtuous and vicious leadership dynamics. The book
proposes that these different leadership dynamics provide an explana-
tion for the divergent effectiveness of inter-organizational networks.
14   M. Mitterlechner

Contributions and Structure of the Book

With these empirical findings, this book contributes several insights
into current debates on leading in inter-organizational networks
(Huxham & Vangen, 2005; Müller-Seitz & Sydow, 2012; Provan et al.,
2007; Sydow et al., 2016), leadership-as-practice (Crevani et al., 2010;
Denis et al., 2001, 2010; Raelin, 2016), and reflexivity in leadership
and management (Antonacopoulou, 2004; Cotter & Cullen, 2012;
Cunliffe & Easterby-Smith, 2004; Gorli et al., 2015).
First and foremost, this book contributes to the inter-organizational
network literature by proposing a novel practice-theoretical model of reflex-
ive leadership in networks. It thereby improves our currently marginal
understanding of how inter-organizational networks are led in different
ways (Huxham & Vangen, 2000b; Müller-Seitz & Sydow, 2012; Provan
et al., 2007; Provan & Kenis, 2008; Sydow et al., 2016).
Second, this book suggests a rare dynamic perspective on leading in net-
works, demonstrating how leadership action and structural properties
at various levels recursively interrelate over time. A dynamic perspective
on leading in networks is timely because leading in networks consumes
and takes place in time (Sydow, 2004) and because it creates knowledge
about how leadership is actually done in networks (Langley, Smallman,
Tsoukas, & Van de Ven, 2013). With this dynamic account of lead-
ing in networks, the book differs from most previous research on this
topic, which has foregrounded either leadership action or structure in a
cross-sectional way.
Third, this book contributes a multi-level study to network research.
Despite several calls (e.g., Brass, Galaskiewicz, Greve, & Wenpin, 2004;
Provan et al., 2007), multi-level research on networks has remained
scarce and still waits to be implemented (Sydow et al., 2016). This book
responds to these calls and proposes a practice-theoretical model that
considers multiple analytical levels—including the organization, net-
work, and organizational field level. The model illuminates how lead-
ership action is recursively intertwined with these three levels. It also
suggests that leading in networks cannot be adequately understood and
explained without considering these three levels.
 1 The Need for Reflexive Leadership in Inter-Organizational …    
15

Fourth, this book contributes to our understanding of leadership prac-

tice in heterarchical networks. In contrast to hierarchical networks, het-
erarchical networks consist of more or less equal partners that do not
formally appoint a leading actor. The book adds a “reflexive twist” to
previous research on this topic (Browning, Beyer, & Shetler, 1995;
Huxham & Vangen, 2000b; Müller-Seitz & Sydow, 2012; Sydow,
2004), shedding light on preconditions allowing members of heterar-
chical networks to reflect jointly on the coordination of activities across
their organizational boundaries.
Fifth, this book constitutes a move toward an understanding of how
reflexivity can be institutionalized in networks (Huxham, 2000; Sydow
et al., 2016). Although several scholars have made calls for more reflex-
ivity in leading networks, we still know little about how this is accom-
plished (Sydow & Duschek, 2011). The practice-theoretical model
suggested in this book offers a dynamic perspective on institutionalizing
reflexive leadership in networks.
Sixth, this book suggests an alternative approach for operationaliz-
ing network effectiveness. The multiplicity of stakeholders involved in
assessing the performance of networks and the normative character of
all assessment criteria makes measuring network effectiveness extremely
problematic (Kenis & Provan, 2009; Provan & Milward, 1995). Sydow
and Windeler (1998) propose that effectiveness assessments are con-
text-dependent social constructions and as such, both outcome and
medium of reflexive leadership action. Denis et al. (2010) shed light
on the substantive, symbolic, and political consequences of leadership
action. This book combines these complimentary research angles in
order to offer a novel endogenous and dynamic approach for empiri-
cally assessing network effectiveness.
Seventh, this book contributes a conceptualization of leadership prac-
tice to leadership-as-practice research (Crevani et al., 2010; Denis et al.,
2010; Raelin, 2016). In contrast to traditional perspectives, leader-
ship-as-practice scholars understand leadership as a social practice rather
than as traits or behaviors of individuals. At the moment, the field
lacks an understanding of how to conceptualize and study leadership
when organizations and networks are considered as a web of conjoined
practices rather than static entities (Crevani et al., 2010). The model
16   M. Mitterlechner

presented in this book provides a possible approach for conceptualizing

leadership as a practice and thus may serve a source of inspiration for
future research on this issue.
Finally, this book contributes to the current debate on practical reflex-
ivity in leadership and management (Antonacopoulou, 2004; Cotter
& Cullen, 2012; Cunliffe & Easterby-Smith, 2004; Gorli et al., 2015).
Scholars in this field have recently argued that the practices that sup-
port or interrupt moments of practical reflexivity have generally been
under-researched (Cotter & Cullen, 2012), and that future research
could explore new methods with which to sustain practical reflexivity
(Gorli et al., 2015). This book provides new insights into such practices
and methods, showing how reflexive leadership action in networks is
recursively related to structural properties at the organization, network,
and organizational field level. On this basis, it shows how reflexive lead-
ership in this context is a dynamic and highly fragile exercise.
This book also contains several implications for leadership practice. Most
importantly, by presenting and empirically illustrating a practice-theoretical
model of reflexive leadership in networks, it provides practitioners with a
novel conceptual tool for reflecting on their own concrete leadership situ-
ation (Feldman & Orlikowski, 2011; Huxham & Vangen, 2005; Langley,
2010). The proposed model, if understood and used as a practical concep-
tual tool, draws attention to virtuous and vicious leadership dynamics in
networks. On this basis, it suggests four “areas of reflexivity” for coping with
these dynamics (see Appendix 6—questions for reflexive practitioners).
This book will proceed as follows (see Fig. 1.1).
Chapter 2 will explore the theoretical foundations of leading in net-
works. The majority of extant research on this topic can be divided into
two streams. Action-oriented studies theorize leading in networks as the
purposeful actions of individual or collective actors. Structure-oriented
studies, by contrast, attribute leadership to certain structural features of
a network, including social coordination mechanisms. Taken together,
the two streams have provided important theoretical foundations for
conceptualizing and describing leadership in networks. At the same
time, the two streams are not without limitations. On the one hand,
their findings tend to be relatively static. On the other hand, there is
only little connection between the two streams as an explanation of how
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