I am a doctoral student in medical management and I have basic training at Uppsala university in Human Relations focusing on organizational sociology. My research focuses on how hospital organizations cope and act on the increasingly complex, changing and unpredictable environment and how hospitals better can link and balance operational and strategic levels in order to meet the needs of patients and using public financing optimally. To date, development initiatives in Swedish hospitals have principally addressed improvement of processes on operational levels and how to improve care processes as such. Less emphasis has been paid to develop the strategic ability of a hospital management to interpret and act on environmental changes. By turning to other research fields, like strategic management and process designs in private industry. We attempt to explore ideas, developed in other fields that potentially could influence hospital organizationis to improve their design of how to link the ever-changing environment to the every day work with care. Being very conscious about the differences in logic between a private market and the public service context, we try to understand what, if any, mecanisms fits the context as a hospital, functions within.