Many analysts characterize the health-care industry and health-care systems as complex adaptive organizations. New hybrid organizational forms are emerging that exhibit diverse relational-structural alliances between physicians, hospitals and/or insurers, over which administrators have limited control and restricted ability to predict or direct. Meeting the challenges in leading and managing health-care systems as complex adaptive organizations calls for additional competency in what theorists determine as 'complex leadership'. This research study presents findings on complex leadership principles that augment those competencies that health-care administration education scholars recognize and recommend as necessary for future leaders in health care to master. The findings from this study make two contributions: first, they ground complex leader theory, derived from complexity science, in empirical data; and second, the findings add to a growing body of literature investigating the underlying logics of the complex adaptive organization and the innovative ways complex leaders are developing practices and principles in leading and managing these new, emerging organizations.

The paper partly rectifies that little research has investigated the enabling structures and processes to manage the environment that surrounds and supports employee participative decision making and new learning to occur at the individual and collective level within a health care setting.

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Purpose -The purpose of this research is to investigate the practices of the interim and current CEOs employed in managing a supportive environment conducive for learning as well as sustaining organizational change; and second, to describe the theory of practice guiding their efforts. Design/methodology/approach -An action science approach, coupled with the case-study data-gathering method to enable a pragmatic grounding of the change processes and organizational learning. Findings -A theory of practice defined as three process principles of power that aid in managing a supportive environment conducive for learning as well as organizational change.Research limitations/implications -The theory of practice set forth combines two advocated views in using power (position power and empowerment) into a framework of reciprocal-relational power. The theory needs to undergo further research to test its applicable knowledge in an action context. Practical implications -Potential guide in helping practitioners in recognizing and implementing processes of reciprocal-relational power to improve organizational learning and the success of change. Originality/value -The paper presents a new way to recognize and see reciprocal-relational forces within a cultural-social-political context.

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