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Thriving and striving on the turbulence of rural health care.

The rural acute care hospital used to be a simple organization before regionalization and integration. Creating a shared vision including interactive planning and strong leadership provides an effective framework for dealing with change and turbulence. Central to dealing with stress and turbulence is the development of strong, trusting relationships with all care providers and disciplines. With strong community relationships within a community health care system, health status can be positively impacted in rural areas.