Management, Structure and Perceived Positive Outcomes of Hospital Alliances: An Exploratory Multinational Study

Pooling resources, knowledge and technologies is a necessity in the health sector. Many hospitals do so through alliances with compatible establishments, which have been studied from the organizational perspective for many years. However, many alliances are reported to fail and the conditions which could foster their success are still not well known. The aim of this exploratory study was to identify the administrative and governance structures of hospital alliances associated with reported positive outcomes. A questionnaire was mailed to hospital administrators and directors from Germany, Switzerland, Austria and Canada. Administrative and governance practices were ascertained and correlated with reported outcomes. Management practices pertaining to initiation, formalization, steering and operations of alliances were correlated with financial, treatment and corporate outcomes. Characteristics significantly linked to perceived positive alliance outcomes include: clearly defined targets and their monitoring, governance by executive management and involving the board of directors, rather formal coordination mechanisms, a project champion and a written contract including conflict resolution mechanisms.