Denis, Jean-Louis creator text xu| 1999 continuing ng p.285-311 This 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 Teaching Hospitals Health services Canadian Public Administration 180718