In the attempt to provide a global vision of the challenges faced by hospitals, this book analyses the dense network of rules and expectations coming from institutions, patients and professionals in which healthcare organisations are embedded. The numerous changes that have occurred within a large part of the healthcare systems during the last 20 years, have determined important consequences, which have been promptly faced by managers. Uncertainty, rules, and innovations are just some of the main ingredients of the challenges to be tackled, whereas mimicry, legitimacy and diffusion of managerial fashions are some of the core strategies implemented to face them. Hospitals survival depends on the ability to intercept on time and to accomplish quickly the external expectations. The role of managers is to create a workplace in which changes are possible. Individual and organisational work value congruence can facilitate it by improving the quality of communication, the degree of trust in hospitals missions, and physicians and nurses knowledge of the processes. Hospital challenges reach up to the single physician, often asking him/her to play new and conflicting roles. The new physician needs to balance his/her time to accomplish ambiguous expectations, to fulfill heterogeneous tasks, and to compete for scarce resources in order to embrace the changes. In this vein, physicians negotiation skills assume a strategic role for the successful running of hospitals.