Even though scholars have widely asserted that ambidextrous organizations need ambidextrous managers, we still know relatively little about the emergence of ambidextrous behaviours among top management team (TMT) members. The purpose of this study is to gain a deeper understanding about how TMT networks and middle management involvement in decision-making collectively shape the ability of TMT members to deal successfully with the exploration–exploitation paradox. Through in-depth interviews and a multilevel analysis of internal networks of 123 TMT members in 20 public hospitals, results suggest that leaders' centrality and the density of TMT networks shape the ability of TMT members to behave ambidextrously. The framework of this paper also incorporates the role of middle management, critical in linking the strategic apex and the operating core, and thereby supporting TMT members’ ambidextrous behaviour. Various theoretical and practical implications are discussed.

尽管学者们广泛断言双元型组织需要双元型管理者，但我们对高层管理团队 (TMT) 成员中双元型行为的出现知之甚少。本研究的目的是更深入地了解 TMT 网络和中层管理人员参与决策如何共同塑造 TMT 成员成功应对探索-开发悖论的能力。通过对 20 家公立医院的 123 名 TMT 成员的内部网络进行深入访谈和多层次分析，结果表明，领导者的中心地位和 TMT 网络的密度塑造了 TMT 成员的双元行为能力。本文的框架还包含了中层管理人员的角色，在连接战略顶点和运营核心方面至关重要，从而支持 TMT 成员的双元行为。讨论了各种理论和实践意义。