Coordination networks within and across organizations: A multi-level framework

There are important organizational phenomena that cannot be fruitfully examined without crossing levels of analysis, as others have shown. We argue that coordination of patient care in the current institutional environment is one such phenomenon. As organizations vertically disintegrate and outsource services that were once produced internally, coordination with external organizations becomes increasingly important for achieving desired performance outcomes. We describe the efforts of one hospital to extend the intra-organizational coordination of patient care to encompass coordination with its external partners. The organization design and network perspectives are both conducive to spanning multiple levels of analysis. We show that the two perspectives together serve as a useful vehicle for developing a framework that links intra- and inter-organizational coordination.