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The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in integrated care models for older adults.

A multiple case study design in two urban centres in two jurisdictions in Canada, Ontario and Quebec. Data collection included 65 semi-structured interviews with policymakers, managers and providers and analysis of key policy documents. The institutional entrepreneur theory provided the theoretical lens and informed a reflexive iterative data analysis.

While each case faced unique challenges, there were similarities and differences in how managers enhanced a partnership’s institutional logic. In both cases, entrepreneurial healthcare managers created new roles, negotiated mutually beneficial agreements and co-located staff to foster inter-organisational partnerships between public, private and community organisations in the continuum of care for older adults. In addition, managers in Ontario secured additional funding, while managers in Quebec organised biannual meetings and joint training to enhance inter-organisational partnerships.

This study has two main implications. First, efforts to enhance inter-organisational partnerships should strategically include institutional entrepreneurs. Second, successful institutional changes may be supported by investing in integrated implementation strategies that target roles of staff, co-location and inter-organisational agreements.

Many entrepreneurs are able to manage their businesses within relatively contained and familiar geographical and cultural circles. With a world economy shrinking every day amid a flood of digital information, todayʼs entrepreneur is increasingly confronted with opportunities to consider new ways to secure vendors and recruit customers. Many unfamiliar possibilities emerge. Should the entrepreneur venture beyond “comfortable” surroundings to consider international connections? Specifically, what about China? How practical is this fetching business temptation of larger markets and lower-cost subcontractors? What are the social, trade, financial, and political issues? Should a “China strategy” be a true entrepreneurial offensive, or rather a defensive response to competition? Is this “China strategy” the promise of yet another entrepreneurial nirvana? Or is it perhaps again a case of “Be careful of what you wish for; it may really come true?”