Leading Academic Integration Through a Foundational Communication Strategy.

SUMMARY In 2012, Alegent Health and Creighton University entered a transformational affiliation that merged a large community-based health system with a century-old academic medical institution. Although strategically promising, the alignment introduced significant cultural, operational, and mission-related challenges. Clinicians, educators, and leaders struggled to reconcile differing expectations, professional identities, and organizational norms. The resulting uncertainty intensified mission misalignment, emotional resistance, and leadership fatigue.This case study examines how communication-grounded in principles of trust and transparency-served as a foundational leadership strategy for navigating this complexity. Rather than relying solely on structural reorganization, leaders used intentional, multidirectional communication to reduce uncertainty, foster alignment, and rebuild trust. Drawing on lessons from the Alegent-Creighton academic integration, this case study offers practical insights for healthcare leaders navigating large-scale transformation amid sustained uncertainty.