Management and structure of hospital alliances

Pooling resources, knowledge and technologies is a necessity in the health sector, both private and public. 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 a list of hospital administrators and directors from Germany, Switzerland, Austria and Canada. Respondents were required to fill out a series of fixed alternative questions as well as some open-ended items which dealt with their perception of and experiences with, inter-hospital alliances. Administrative and governance practices were ascertained and correlated with reported outcomes. Descriptive analysis and correlations were computed using IBM SPSS statistics software. Management practices pertaining to initiation, formalization, steering and operations of alliances were correlated with financial, treatment and corporate outcomes of the alliances. 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. Selected structures, processes and governance practices of hospital alliances are correlated with success and therefore worth taking into account when crafting an alliance. These conclusions are derived from a multinational study and therefore could be applicable across different systems of health care.