Fragmented corporate governance infrastructure leads to disparate local markets processes. The attempts to centralize and standardize the management and delivery of the health systems are falling short. This forces local markets to develop programs that fill the gaps when faced with an immediate operational need and there is no defined solution from the home office.
When the local process are developed, the talent is not recognized for finding solutions but reprimanded for not following the central leaderships programs, placing a the resource in a "double jeopardy". This results in a devaluation of good people who are trying to do the right thing by creating solutions for immediate operational needs.