• Trends shaping the future of hospitals include chronic disease epidemiology, rapidly increasing health insurance coverage, E-Health, globalization, and people-centred care.
• The challenge for major service units of large hospitals is to vertically integrate community based services and facilitate networks of excellence in their specialties. The challenge for hospital governance is to horizontally integrate the major service units.
• Hospital management and design should support data driven continuous improvement, ongoing rapid evolution of service models, and a deep commitment to serving the community, however defined.
