01100pab a2200157 454500008004000000100002200040245005600062260000900118300001400127362000900141520071000150650001300860650001400873650002000887773003500907180718b1999   xxu||||| |||| 00| 0 eng d  aDenis, Jean-Louis  aThe struggle to implement teaching-hospital mergers  c1999  ap.285-311  aFall  aThis paper presents some initial results from a longitudinal study of two major hospital mergers (involving three large institutions each). After examining the context of the two mergers and the cultures that must be integrated, we describe the processes of pre-merger negotiation, leadership development, strategic framing and operationalization. Despite very different processes that seem on the surface smoother in one organization than in the other, both organizations have experienced difficulties in achieving successful operationalization. We conclude that the context of limited resources, diffuse power and divergent cultures are largely responsible for the difficulties experienced. - Reproduced  aTeaching  aHospitals  aHealth services  aCanadian Public Administration