In analyzing a reform process at a Norwegian hospital, a central finding wa
s that successful leadership depends upon actors assuming a communicative m
ode of interaction. This contradicts the instrumental view of leadership un
derlying the New Public Management approach, whose emphasis is on efficienc
y and goal achievement through employment of external sanctions. How can it
be that leaders who give priority to reaching common understandings rather
than on realizing specific goals are more successful? The unique feature o
f communicative leadership is its focus on legitimacy, which is achieved th
rough rational conducted deliberation aimed at solving problems and resolvi
ng conflicts. This article depicts the varying organizational conditions fa
voring communicative leadership, such as decentralization, co-decision-maki
ng, and team-leadership. More specifically, delegation, reduced span of con
trol, and dispersion of power are among the factors that contribute to a co
mmunicative mode of coordination.