A senior manager in a hospital is determining a system-wide approach linking physicians, social welfare agencies, and single issue volunteer health organizations in a coordinated network. The approach taken will determine likely success or failure of this innovative approach. The hospital faces a problem as the initiator of the network, as it is a teaching hospital and is viewed by many in one community as too big. The decision maker has to be able to sell the idea to the board (who seek accountability), the various agencies (who seek direct benefits) and the community at large (who seek a seamless health care delivery system). Thus potential conflicts and trade-offs abound.
