title: The unfocused strategic vision.
abstract: Integrated delivery systems are often seen as the answer to the question of how to deliver high quality health services to a defined population at the lowest possible cost. This case examines the birth, growth, and ultimate demise of one such system. At first glance, all of the elements necessary for a successful integration were present including visionary leadership and a well defined strategic plan. However, the senior managers did not foresee the problems that would result from a clash of organizational cultures, significant mistrust between and among staff and physicians, and inability to manage the emotional-cognitive landscape.
authors.affiliation: Oregon State University, Corvalis, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Friedman
mesh_terms: D018672:Community Health Planning; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration*; D004465:Economic Competition; D006301:Health Services Needs and Demand; D006759:Hospital-Physician Joint Ventures / Q000191:economics / Q000458:organization & administration; D007324:Institutional Management Teams; D007400:Interprofessional Relations; D007857:Leadership; D017146:Models, Organizational; D009096:Multi-Institutional Systems / Q000191:economics / Q000458:organization & administration; D015279:Organizational Culture; D009936:Organizational Innovation; D014481:United States