The co-leadership dance: the building of a managerial we in functionally shared leadership in healthcare

Purpose Changing healthcare organizations call for more collective and team-based approaches to leadership. This study focuses urgent care units in Sweden where unit managers and physicians responsible for medical management are expected to co-lead as equals in the organizational hierarchy in a form conceptualized as functionally shared leadership (FSL). This study aims to increase the current scientifically based knowledge about putting FSL into practice. Design/methodology/approach Data was collected through interviews on two occasions with individuals in couples leading six publicly driven urgent care units, and through conversations with the department manager of these units. Data was analyzed in two steps, first with individuals and second with pairs as the basis of analysis. In step 1, an iterative, thematic approach was used. In step 2, the theoretical points of departure served as a lens to direct our focus. Findings Amid handling ordinary work tasks and new challenging situations, the couples worked to shape a shared leadership space. Three intertwined activities were identified: working with boundaries, working with structures and relating to each other. The presence of a shared purpose emerged as the glue of co-leading. Metaphorically the couples perform a co-leadership dance where the steps of either influence the other. Originality/value The study contributes knowledge relevant for healthcare contexts as well as to the research field of managerial shared leadership concerning cross-functional sharing. It adds understanding of previously understudied informal and processual aspects. The shaping of a shared leadership space is not a separate activity with ready-made mandates.