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Rapid development of land-based units in Operation Desert Shield/Storm presented critical needs for medical support. Integration of small Navy mobile medical teams in Bahrain and a larger United States Army Hospital unit in Riyadh, Saudi Arabia, at host nation hospitals presented an innovative method of providing this support. The success of these ventures in convenience and quality of care establishes the host nation interaction with military medical professionals as a workable, satisfying, and important adjunct to standard military medical care.

Ten human factors affect the implementation of knowledge management initiatives, including fear, cultural change, capturing of tacit knowledge, ease of use, stakeholder involvement, and benefits realization. To deal with these factors, a phased change management approach is offered, consisting of an assessment, strategic planning, organization development, systems design, orientation and training, team building, and continuous evaluation and improvement.

This case describes the experience of the Detroit Medical Center (DMC) in restructuring its governance and management. It provides a background on the DMC, examines the driving forces that led to modification of its structure, identifies key principles in guiding the change, and describes the strategies and specific steps taken in managing structural change. Finally, the critical lessons learned about leadership style, communication, agenda development, and relations with the board, medical staff, and management are discussed. This case study will help reduce the learning curve for any large, complex organization undertaking board and management restructuring to better meet its mission. At the time of DMC's restructuring there were no models to guide the effort. This case study attempts to reduce the gap in research on the management of structural change.

Rapid development of land-based units in Operation Desert Shield/Storm presented critical needs for medical support. Integration of small Navy mobile medical teams in Bahrain and a larger United States Army Hospital unit in Riyadh, Saudi Arabia, at host nation hospitals presented an innovative method of providing this support. The success of these ventures in convenience and quality of care establishes the host nation interaction with military medical professionals as a workable, satisfying, and important adjunct to standard military medical care.

This paper describes how the King Fahad National Guard Hospital in Riyadh, The Kingdom of Saudi Arabia, integrated United States Army (USA) medical units and prepared the hospital to receive war casualties during Operation Desert Storm. In particular, preparation of the hospital, the staff, and military systems are reviewed. The report will also discuss operations at the hospital during Operation Desert Storm and the major lessons learned. Comment is provided by the host nation hospital regarding the impact of the experience with the USA medical units and their personnel.