Hospital turnarounds: agents, approaches, alchemy

Hospital turnarounds are an increasing phenomenon in an era of unrelenting financial pressure on the health care delivery system. However, the literature about hospital turnarounds contains more theories and case reports than research studies, and repeat turnarounds suggest that there is inadequate evidence about what really works. The essential role of the turnaround agent in strategy formulation and especially strategy implementation is the subject of this article. It casts a wide net over the literature of strategy, change, leadership, and management. The article traces the nature and evolution of hospital turnarounds plus the agents that effect them; summarizes the turnaround agent's 10 most potent approaches to strategy analysis and synthesis; and outlines 3 research questions about first, the recurring need for hospital turnarounds altogether; second, longitudinal evidence to support different turnaround approaches; and third, the mechanisms by which the turnaround agent both changes and is changed by the distressed hospital.