Strategy Formation in Complex Organizations: The Evolution of Strategic Issues in Hospitals

This study investigates strategy formation in complex organizations. Particularly, the empirical research focuses on the integration of medical and management expertise in strategy formation and tracks the evolution of... [ view full abstract ]

This study investigates strategy formation in complex organizations. Particularly, the empirical research focuses on the integration of medical and management expertise in strategy formation and tracks the evolution of strategic issues in hospitals.

Theoretically, the collaboration of medical and management expertise is conceptualized by the differentiation into intended and unintended strategic issues (Mintzberg, 1978). Furthermore, the evolution process of strategic issues is conceptualized by the well-known process model of strategy making by Burgelman (Burgelman, 1983, 1991). Hence, as the successful evolution of strategic issues is of utmost importance, this study focuses on the variation, selection, and retention of intended strategic issues and unintended strategic issues.

An empirical study is conducted on how strategic issues evolve in a hospital group that uses a combination of medical and management expertise in strategy formation. On the basis of the empirical findings, a model of the evolution of strategic issues in hospitals is developed. Overall, this study contributes to a better understanding of strategy formation in complex organizations by discussing empirically elaborated constraints and supportive factors in the evolution of strategic issues in hospitals.