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This paper reports findings from an eight-year ethnographic study of the integration process in a large healthcare system formed in a 1994 merger. We examine the postmerger integration process by analyzing the relative amounts of time that senior managers in one unit of this organization spent discussing various integration topics and issues in their bi-weekly meetings from 1995 to 2002. We also describe the different patterns observed when managers addressed topics in their meetings related to internal unit integration versus integration with other parts of the organization. Finally, we identify a vicious cycle of repeated conflicts in how organizational members made sense of issues that emerged during the post-merger integration journey.

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