Challenge 1: Environmental Linkages
HPO is an open system, influenced by external environment and influencing it in turn
Need to keep tuned in to changes in environment, e.g., changing customer expectations
Need to develop missions or visions that focus all energies on how the organization addresses its inputs (problems and opportunities); involvement of all employees in vision directing is crucial for acceptance
Need to be aware that outputs include not only the product or service provided, but also impact on quality of life of organizational members, impact on society through activities