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1. Integrated settings for managing contradictory expectations of relevant subsystems:

The case study confirmed that managers' handling of steering contradictions inherent in health organizations (a crucial success factor) can only be balanced by dialogic negotiation processes. Integrated setups of in-house-programs give the opportunity to learn how to handle contradicting expectations of different subsystems of the organization. This requires the following steps:

First, the participants of the course-group have to be enabled, on the one hand, to clearly differentiate between the different requirements of subsystems (such as economy, policy, patients/relatives and science) and to increase their empathetic understanding by transforming prejudices into new insights. On the other hand, they experience the necessity of deciding a specific combination of these logics within their leadership practice.

Second, the task of steering an in-house program as an overall process as well as the change projects included in the program demands continuous perceiving and balancing of contradictory needs and expectations of all parties involved.

2. Communication settings:

We would like to emphasize that the learning setup and change setup turned out to be essential in addressing the development of leadership behavior as well as the structure and processes of the organization. Additionally, the steering setup allowed the strategic implementation of targets within goals and contents of the leadership trainings and the OD projects while simultaneously enhancing leadership learning for all managers involved. Continuous reflecting on and balancing of the different speeds of individual and organizational learning called for appropriate, context-tailored interventions by the steering setup.

3. In-house programs:

The case shows that in-house programs—realizing a combination of individual and organizational learning within an organization -offer a fruitful context for successfully building cultural islands. Cultural islands operate as secure transformation spaces for managers to experiment with not only new mental models but also leadership behavior strengthening each other via positive feedback loops (Schein, 2009). To allow a paradigm shift within management culture, the integration of a critical number of participating managers within in-house programs is a precondition.

4. A specific counseling approach:

Consultants and clients have to steer complex in-house programs jointly to meet the demands and standards of all stakeholders integrated (e.g., by contract of cooperation, internal/external-project management). It also means to set up clear rules and new routines between the parties involved.

The complexity of these programs—mirroring the complexity of the client organization—must be matched by the counselor system and specific competencies of the staff members (trainers, consultants, lecturers) must be available. The presumed counselor staff has to be educated in both disciplines (HRD and OD) to consult such complex programs.

In order to be able to implement dialogue-based negotiation processes, counselors must act as reliable role models within negotiation processes regarding targets, contents, cooperation roles, equality and transparency. This means that clients must have the opportunity to watch counselors' learning while changing their patterns of observation and acting. Learning as a self-referential process includes clients and counselors.

5. Distinction between contracting and counseling system:

Managers and counselors should be aware that the differentiation between a contracting system and a counseling system is necessary in order not to mix the logics of top-down management and negotiation dialogues. Regular meetings between the top management and counselors (contracting system) to actualize goals and to evaluate the progress of the integrated in-house program turned out to be a critical success factor. Additionally, this also calls for special project meetings between the internal and external project manager.

This overall contracting setup offers the framework for top-down decisions of top management and gives free space for joint decision making within the counseling system with respect to the leadership development process.

6. Opportunities and limits of integrated organizational setups for management learning:

This approach turned out to be very helpful for organizations forced to change from a primarily political to a more economic logic within a very short time. In particular, the required change of management, organizational structures and procedures demanded new ways of processing learning on organizational, management and individual levels. Additionally, we assume that this integrated approach works well within large enterprises addressing and balancing the different leadership cultures of specific organizational units and enhancing a joint identity.

We expect that this approach does not work when the case for action is to handle escalated crises. The latter demands a quick setup of new strategic targets and cooperation patterns whereas the integrated in-house setup presumes a new strategy and the joint willingness of top management to transform the new strategy within a short time into everyday routines. In addition, for projects primarily addressing the increase of efficiency beyond sustainable learning processes, this integrated approach does not fit.


1. In chapters 2.2 and 2.3, the authors cite key messages of their article "Between all chairs: Change management in health organizations in the tension area of different steering logics" (Barton, Garbsch, & Wilhelmer, 2011, p. 30).


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