Management Control Systems (MCS) change and the impact of top management characteristics. The case of healthcare organisations

the objective of this article is to answer the following research question: how can actors implement management control systems (MCS) change processes if their actions and rationality are conditioned by the institutions they wish to change? More specifically: (i) how do individual variables of the top management team interact with external dynamics? (ii) how do individual variables of the top management team interact with intra-organisational dynamics? In that respect, the article analyzes the change process implemented by an Italian independent hospital, using a processual research approach. The article deals with the dynamic interactions between individual characteristics of the top management team (TMT) – as codified by the upper echelon perspective - and the social external and intra-organisational variables identified by institutional studies. Our findings show how leadership and heterogeneity of TMTs interact with internal and external dynamics and play a key role in the change process analyzed