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Managing Strategic Alliances
Edward J. Zajac and Thomas D'Aunno Health Care Management: Organizaiton Design and Behavior, 3rd Edition, Shortell, Stephen M. and Kaluzny, Arnold D. 1994

There is no doubt that the U.S. health care environment is undergoing major changes that could be characterized as turbulent. The word was originally used to depict highly complex and rapidly changing environments; "turbulence" has been somewhat vaguely used to describe many industry contexts.2 However, a closer inspection of the Emery and Trist definition reveals that the term applies when two general conditions are met: (1) organizations are highly interconnected with one another, and (2) organizations are highly interdependent with the society in which organizations find themselves. This emphasis on connectedness and interdependence is an important basis for viewing a specific organization's environment not as some amorphous external force but rather as the set of other organizations that are interconnected or interdependent
with it. This organization, in turn, is part of the environment for the other organizations. In other words, when an organization looks out with concern or anticipation at its turbulent environment, what it sees is other organizations looking out at that organization. This conceptualization of organizational environments suggests the need to focus more attention on how specific organizations interact with one another. This chapter emphasizes one such type of interaction; namely, cooperative interorganizational relations. Longest, in discussing what he terms "interorganizational linkages in health care," distinguishes between market transactions. voluntary relationships, and involuntary relationships. We focus most of our attention on those interorganizational relations that are noncoercive and entered into primarily for strategic purposes, that is, that are important to an organizations mission and expected to enhance organizational performance. Such relationships we term strategic alliances. which are defined as any formal arrangements between two or more organizations for purposes of mutual gain.

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