It takes a long time. Articulating and understanding vision and strategy is critical. Once a model is developed it goes faster. Physicians are the best internal and external salesman. The interests of the participants produce creative tension.
Real deadlines create focus.
It requires trust. It requires the CEO of the organization and the medical staff leadership to be in syc and to be intimately involved. Must understand antitrust issues. Getting the right consultants is tough. Finding the right legal talent is critical.