The main purpose of this article is to verify how the process of strategic change happened in a hospital organization. An empiric analysis of the strategic changes that occurred in CBS Hospital in the last 20 years is developed. The direct conditions (real environment, cognitive arena) of the sector are identified as perceived environment and the network of collaborators that support the hospital's activities is determined.The period of major transformation was from 1991 to 1995, and the main changes were in the hospital culture, the doctors' and staff's work philosophy, the training way of the staff, the organizational structure, the process and the technology. It was perceived that the hospital dominant coalition is affected just by external influence due to some technologic changes and that, internally, the clinic body has control over the decision making process.
Strategic change; direct conditions; cognitive arena; collaboration network