We set out to write an in-depth case study of Doctors Community Hospital (DCH), a not-for–profit organization located in Landham, Maryland. Given our initial findings, we tried, in inductive fashion, to explain the success of DCH in terms of established theory. We turned first to Michael Porter (1996), but did not find in his model adequate emphasis on the role of organizational culture, an element we believed was central to understanding the performance DCH. Thus, we subsequently turned to the work of Edgar Schein (1985, 1992) and of John Kotter and James Heskett (1992). We gradually realized that while the respective models described relations between culture and strategy, culture and environment, or strategy and environment, none among them provided an articulation of the clear, strong, and balanced links among the three elements that we perceived to be central to the case of DCH. Thus, we constructed a simple framework that synthesized the insights of the three approaches. Our framework permitted us to offer two propositions. The first posits four conditions necessary for an organization to achieve success. The second posits four conditions one would expect to see in a successful organization that attempts to adjust to a changing environment. Although our framework is based on inductive reasoning and evidence from one organization, we believe and hope our insights will be helpful to others.