This article examines the role of middle management in facilitating or hindering the implementation of complex changes in health care organizations. While research has affirmed the importance of middle management support in the execution of new initiatives, little is known about which factors influence middle managers’ support of significant reforms.
The authors conducted semi-structured interviews and focus groups with 92 middle managers from 19 health care organizations in the Jobs to Careers: Transforming the Front Lines of Health Care Program. They then coded and analyzed the results of these interviews and focus groups.
This research suggests that health care organizations implementing major new initiatives may receive more support from middle managers when the initiatives are aligned with the goals of individual departments and when middle managers have control over the implementation of change within their units.