McMaster Family Health Team: Culture Evolution

In 2016, the chair of McMaster Family Health Team faced challenges related to differences in operational culture that had emerged at its two clinic sites—Stonechurch Family Health Centre and McMaster Family Practice. The two sites, which had operated independently with relative autonomy for over 30 years, were merged in 2015, in response to a government initiative, a new funding model intended to increase access to primary health care for all Ontarians. The original goal was to operate the two sites under one model, one set of standard operating procedures, and one common governance framework. Over time, however, two distinct team operating cultures evolved organically at the two sites. The identity of both sites was consistent, but they differed in functionality. The chair's goal was to continue growing the clinics, but he needed to decide how best to proceed. Should he allow the two sites to continue operating with different functional cultures, and possibly allow other future sites to also organically develop their own identities and cultures? Or should he proactively influence a standardization plan?