It's a huge organization that has grown by 'folding in' other organizations. The hospitals each have their own board and bylaws which sometimes conflict with each other and complicate workflow, but the legal and compliance teams are working to bring us to a fully standard set of system policy. Some departments and teams are petty and tribal about what they see as their domains; sometimes different teams are trying to solve the same problem, but they aren't in communication with each other. Even when good changes are proposed, they tend to take a long time to be implemented or get adopted by end users.
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