“…These include limited resources, conflicting beliefs (e.g., philosophical and/or political), and confidentiality concerns (Florin et al, 2000;Hammett, Roberts, & Kennedy, 2001;Mitchell & Shortell, 2000). Issues of territoriality, conflicting goals, lack of trust, and differences in perceived status have also been identified (Gittell & Weiss, 2004;Himmelman, 2001;Sherman, 2004;Wolff, 2001a), as well as differences in decision-making styles and performance assessment (Berkowitz, 2001;Florin et al, 2000;Mitchell & Shortell, 2000;Provan & Milward, 2001). At the practitioner level, these challenges are primarily institutional restrictions (e.g., time constraints, staff turnover, or limited funding) that impede the ability to work collaboratively to address common problems (Taxman, Young, Byrne, Holsinger, et al, 2001).…”