Facilitation and negotiation are skills you will use on a regular basis as a leader in health care. Last week you worked with your group to research best practices and apply them to a merger of two wo
1Week 2 Group Assignment: Hospital Merger and Culture Considerations
Princess Lacy, Keary Janet, Jessica Espinoza, Nicole Tate, Michelle Garcia, & Kairi Pangelinan
University of Phoenix
Sector Stakeholders: Identifying and Cultivating Alliances/MHA 520
Dr. Tomeka Small
November 11, 2024 2
Week 2 Group Assignment: Hospital Merger and Culture Considerations
Princess Lacy
Merging healthcare organizations requires a careful approach to integrate different
organizational cultures successfully while ensuring quality care, cost efficiency, and expanded
service access. This integration process must prioritize addressing employee resistance and
potential challenges to facilitate a seamless transition. High-level executives need to focus on
issues that significantly impact success, such as addressing the concerns of various personnel
groups, overcoming stereotypes, and promoting open communication.
Personnel groups, including clinical staff, medical staff, administrative staff, and support
services, are all affected during a merger. Clinical staff like nurses and technicians may need to
adapt to changes in work protocols and departmental structures. Medical staff, including
physicians and specialists, might face new treatment guidelines and altered reporting structures.
Administrative staff who manage human resources, finance, and IT need to transition to new
policies and systems while ensuring smooth documentation and operations. Support services
staff, such as maintenance and dietary teams, may experience changes in operational standards
and resources, all of which can affect their day-to-day functions. For these reasons, paying
attention to the specific impacts on each group is vital to avoid disruptions and foster a smooth
transition.
Cultural integration in mergers comes with significant challenges. Resistance to change is
common, especially when clinical and medical staff are accustomed to established care practices.
This resistance may stem from fears of job loss or loss of control over work methods. Differing
clinical and administrative protocols also pose a challenge, as patient care and procedural
standards often vary between merging entities. Coordination is essential to ensure consistent, 3
quality care. Communication barriers can further complicate integration, especially if
terminology differs across organizations, leading to misunderstandings. Additionally, integrating
technology, such as electronic health records (EHRs), involves technical complexities and
necessitates staff retraining.
To address these challenges, a comprehensive strategy is needed. Starting with a cultural
assessment helps identify each organization’s strengths and areas needing alignment. Cross-
functional integration teams that include members from all personnel groups can help identify
problems early and develop solutions collaboratively. Establishing a shared vision and mission is
crucial, emphasizing a unified approach that aligns with core values and operational goals.
Effective training programs tailored to each group’s needs ensure that staff are equipped to
handle new systems and protocols.
Negotiating buy-in from staff is essential for a successful integration. Inclusive decision-
making that involves representatives from different groups fosters collaboration and creates a
sense of shared ownership. Transparent communication builds trust by openly sharing the
benefits and potential challenges of the merger. Highlighting the advantages, such as increased
resources and professional opportunities, helps staff see the merger’s value. Creating avenues for
anonymous feedback ensures concerns are heard and addressed promptly.
Communication plays a critical role in supporting the integration process. A designated
leader, like a Chief Integration Officer (CIO), should oversee communications to maintain
consistency. Weekly town hall meetings, newsletters, and an intranet portal with updates and
Q&A sections help keep all staff informed and engaged. Communication should also outline
timelines, role changes, and available support resources to assist employees through the
transition. 4
Achieving buy-in requires continuous staff involvement from the outset. Celebrating
small victories and “quick wins” helps reinforce the merger’s benefits and maintains morale.
Leadership should model the new organizational culture to demonstrate commitment and set the
tone for the entire organization. Ultimately, successful cultural integration in healthcare mergers
hinges on strategic planning, clear and honest communication, and active involvement from all
levels of staff, creating a robust culture that enhances the quality and affordability of healthcare
services.
Keary Janet
Background
My hospital has recently merged with a group of medical centers. As a high-level
executive, Group 1 has been asked to develop and implement a strategy to integrate the two
cultures. Success with this effort must also translate into the optimization of patient care, quality,
safety, cost of services, and access to care. According to Healthcare Executive, “ The healthcare
industry continues to trend toward high rates of mergers and acquisitions in 2024. Experts
expect the rate of mergers and acquisitions to continue to increase .”
The core personnel groups substantially affected by the recent merger include physicians,
nurses, medical assistants, administrative staff, management teams and patients (stakeholders).
All personnel may experience changes in workflows. Unfortunately, with the merger, there will
be positions eliminated due to redundancies. Additionally, benefits and compensation may be
affected. Challenges and cultural clashes between the merging institutions due to current
workflows or standards can lead to stress, team-member turnover, reduced optimism, and low
productivity. Patients may feel overwhelmed and anxious about their care and if there will delays
in appointments, new practitioners, and/or if the cost of visits, procedures or prescriptions will 5
increase. Mergers are always challenging, and affect all stakeholders, especially in the ever-
changing complex healthcare industry. However, mergers can be successful with buy-in from all
stakeholders if key strategies are followed.
Transparency
Provide detailed communication about the merger's objective, timeline, and potential
impacts on team members such as responsibilities, benefits, job security and compensation. New
SOPs and workflows that will be utilized. For example, will each organization continue with
their current EMRs, workflows, vendors, etc. (I have witnessed this in practice.) This
communication should be put forth in electronic communication from both organization’s
leadership. Simultaneously, communication should be conveyed to the community and patients
to describe how their care may be affected, changes in cost and if their insurance will still be
accepted. The overall goal is to decrease worry and build stronger relationships amongst all
stakeholders. Mass communication should occur via social medial platforms, media ads and print
highlighting how the merger will improve patient care by enlarging the pool of specialized
services to provide immediate care to patients, new service lines and programs that will be
offered to the community to provide improved healthcare and outcomes. Communication should
be ongoing throughout all phases of the merger.
Integration of Cultures
Leadership of both organizations must actively communicate with team members using
electronic communication, dedicated web portals and department huddles to reach all employees
to increase awareness of the merger and allow conversations to begin on what changes will
occur. Holding town hall meetings via Teams at various times to talk about benefits of the
merger, what to expect, timelines, and addressing team member concerns regardless of role to 6
create open communication. This will build employee confidence, transparency and build buy-in.
During the town hall meetings, team members should have the opportunity to ask questions
anonymously to the leadership panel. Management will provide the opportunity for team
members across all functional departments to collect feedback, identify possible challenges and
to collaboratively develop resolutions. Leadership should acknowledge and respond to possible
cultural differences between the organizations and enthusiastically work to channel differences
during coaching and partnerships. Perhaps create a new logo, rebrand with team member
involvement. Additionally, management should offer information on how the merger may
provide cost savings to all stakeholders, including keeping practices open and potential benefit
savings on health insurance for employees. This should also include regulations, approval and
processes and how the cost of services may have an impact on the community in which the
organizations serve.
In conclusion, team members of Group 1 provided great responses and precisely offered
best practices strategies and solutions in their individual summary. All responses were precise
and well-articulated in capturing challenges and offering solutions to reduce stress from all
stakeholders due to the merger.
Reference
4 Ways to Support Healthcare Workers During Mergers and Acquisitions . (n.d.).
Healthcareexecutive.org. https://healthcareexecutive.org/sponsored-content/4-ways-to-
support-healthcare-workers-during-mergers-and-acquisitions
Jessica Espinoza 7
My original strategy was being able to have open communication with all employees of
the merger. With a big change that happened when merging from a medical center to now a big
hospital organization. Keeping an open door to all Doctors, IT department, surgical, nurses, all
employees etc. So, I do not think that all of the employees should have a say so in what happens
because some people do not put the organization first, but themselves. For those employees that
are in a leadership role when the merger happens it’s because they have been able to prove they
can put the organization first. When merging a medical center into a hospital the top priority is to
look out for what is best and that leads to making sure the most highly experienced and highest
ranking. With merging different organizations also comes with a lot of challenges that may not
be able to fix. Certain challenges would be hard because of the different cultures coming
together. The feedback I got was bases more on how my employee discussion was. The medical
field has one of the highest turnover rates. When you break it down you can see where more
issues are arising and causing these turn over rates. One of them being under paid and over
worked. Or the fact that they miss events in their lives, their family lives all because of the field
that wanted to go into.
The main point I talked about was the turnover rate is the number one reason the health
field loses their employees. When COVID 19 happen, employees were put under so much
pressure and stress due to the field they were in. Then, A lot the regulations and rules are about
the same for each organization, so why would they switch from one organization to another
when it would be the same thing over and over again, thus making the employees leave and their
turnover rate go through the roof. I did get a lot of great feedback from my group this week, and
ideas that I could add or even be able to elaborate on. I would modify some parts of my first part
submission to be able to add and go into more detail about the financial section. That is one 8
section that I did not fully touch on enough. And in the health care field financial is a major
section to always have in the back of one’s mind. One thing that I would decide on a solution
was to have a suggestion box. I know that hospitals have meetings all the time, but some
employees may not want to speak up in front of their peers. So, I would have a box that you
don’t need to show your name, badge number, etc. But it’s an open door to let those who don’t
want to actively speak in person still feel like they have a say so. That may be able to fix some of
the problems that have arisen.
Nicole Tate
Reflection on Strategy for Merging Workplace Cultures
When approaching the challenge of merging two distinct workplace cultures, my original
strategy focused on addressing key operational and cultural challenges with a clear
communication plan and structured leadership alignment. Merging healthcare organizations often
involves reconciling differences in mission, values, leadership structures, and day-to-day
operations. Given these complexities, I proposed a multifaceted approach that included
communication across all levels of the organization, strategic leadership involvement, and
alignment of both clinical and medical staff around shared goals.
First, I emphasized the importance of communication, particularly between leadership,
management, and staff. Miscommunication or lack of transparency can exacerbate resistance to
change, leading to a disengaged workforce and operational disruptions. Therefore, my strategy
suggested holding regular meetings with staff at all levels, including town halls and feedback
sessions, to discuss expectations, challenges, and updates throughout the integration process.
Leadership should take an active role in these communications, with the CEO or equivalent 9
acting as the chief communicator, delivering consistent messages about the merger’s progress
and addressing staff concerns directly.
Additionally, I acknowledged that merging the operational systems and daily workflows
of clinical and medical staff would require significant adjustments. For example, the integration
of electronic health records (EHR) systems must be managed carefully, as differing platforms or
protocols between institutions can create operational friction. I proposed cross-functional teams
to work on aligning EHR systems and identifying best practices for daily workflows to minimize
disruptions. It was also important to address the differing leadership structures between the two
organizations. Aligning key decision-makers and clarifying authority structures would ensure
smooth integration without causing unnecessary tension between the old and new leadership
teams.
The strategy also called for the identification and harmonization of the organizations'
mission, vision, and core values. As Riney (2024) pointed out, clear communication around
values and organizational culture is crucial for a successful merger, and without aligning these
fundamental elements, the merger could falter. I recommended developing a joint vision
statement and fostering a shared sense of purpose through workshops, leadership alignment
exercises, and other team-building activities to ensure that all employees felt a sense of
ownership in the new organizational culture.
Feedback and the Decision to Retain the Strategy
Based on the feedback I received, I would not modify my original strategy. The group
discussions highlighted several points of agreement with my initial approach, particularly
regarding the importance of communication, leadership alignment, and the careful management
of cultural integration. The feedback also emphasized that acquiring organizations often succeed 10
due to their ability to manage cultural differences and engage employees at all levels in the
process, a point I had already integrated into my strategy.
The suggestions regarding incorporating personalized communication strategies for
different stakeholder groups were valuable, but I feel that my original strategy already addressed
this through various communication channels, such as town halls, newsletters, and digital
platforms. The addition of more tailored communication is important, but I believe the existing
plan provides sufficient flexibility to accommodate the diverse needs of staff.
Alternative Solution
If I alone could decide on a solution following group discussions, I would focus on
creating a more robust feedback loop throughout the integration process. While communication
is critical, ensuring that feedback is not only received but also acted upon in real time is essential
for addressing concerns quickly and adjusting strategies as needed. A continuous feedback
mechanism—such as surveys, focus groups, or digital platforms where employees can voice
concerns and suggest improvements—would help ensure that the merger is not only
communicated effectively but also flexible in its response to staff needs.
Rationale
This solution addresses the evolving nature of merger integration, where challenges may
emerge unexpectedly. Continuous feedback would enable leadership to stay in tune with
employee sentiment, identify operational roadblocks early, and adjust strategies accordingly.
References
MBA Healthcare Management. (2024). The challenges and strategies in healthcare mergers:
Case studies and best practices . 11
Riney, M. (2024). Healthcare mergers and acquisitions: Cultural integration and leadership
alignment. Journal of Healthcare Management, 29 (4), 88-101.
Michelle Garcia
While it is believed that hospital mergers are a solution to efficient patient care, many
worry these will be a fall at mission shifting the cost for the mergers to the patients’ fall. With
the support of value-based care and drastic changes to patients are receiving health services, the
ability of smaller local hospitals to survive independently reduces and the need for more efficient
treatment options. Hospital mergers have been an increasing trend in the healthcare market with
many proponents of mergers believing that there is an overall consolidation of hospital services.
Healthcare mergers or acquisitions involve larger health systems collaborating or partnering with
smaller facilities in which it may be helpful to increase access to care promoting specialists.
Mergers and acquisitions are an opportunity to bring together the best of all involved. Expanding
services and access to more providers or specialists means expertise and resources to resources.
Smaller hospitals and health systems may benefit from the sources. Mergers in healthcare can
lead to a significant shift in patient care, quality of access and cost in some cases not for the
better. Hospitals may not always pass on the rising cost of supplies, medications, labor to payors.
The organization seeks out mergers and acquisitions to increase their pricing power due to the
impact inflation on operating cost. By combining resources, the healthcare system may offer
more services to a wider range of patients after a merger or and invest more. Healthcare mergers
sometimes prevent hospitals that are struggling financially from filing for bankruptcy or closing.
It is always a good idea to work with an organization who has experience with mergers. One of
the most important tools hospitals can use to increase access and quality of care and manage risk
and financial pressure are mergers and acquisitions. Hospitals improve access to care by 12
broadening the type of specialists or services that are available to patients. Financial pressure can
prompt mergers and acquisitions as providers struggle to access the resources they need to care
for their communities. Financial pressure may result from the cost of complying with complex
local, state and federal regulations, commercial payer administrative requirements. Healthcare
mergers and acquisitions sometimes prevent hospitals that have struggled or are struggling
financially from filing for bankruptcy or closing. Hospitals will need to carefully review their
practices, procedures and facilities during and after a merger ensure staff are well prepared and
trained for new challenges. Executives who engaged in mergers and acquisitions that did not
meet cost and quality goals did not focus on integration. Providers should identify team leaders
as early in the merger and acquisition process as possible. To have value and avoid antitrust
challenges, an organization growth strategy should prioritize improving care quality and
reducing cost in their market. Small independent hospitals are often extremely customer service
oriented and supported by the community. They have a single integrated system from one vendor
with basic functionality and limited integration points with other applications. We are also
seeing some hospitals coming into partnership discussions with a level of distress.
References
Jacqueline LaPointe, How Do Hospital Mergers Lower Cost, Quality Improvement?,
TechTarget, Recycle Intelligence Xtelligent Healthcare Media (Jan 26, 2017)
https://recycleintelligence.com/new/how-do-hospital-mergers-lower-cost-drive-quality-
improvement.
Tara Bannow, Patients, Doctors Press FTC to Beef Up Hospital Mergers Scrutiny, STAT
Reporting from the Frontiers of Health and Medicine (Sept. 18, 2023). 13
http://www.statnews.com/2023/09/18/ftc-hospital-merger/, see also Nadia Dreid, FTC
Too Busy to Scrutinize All Hospital Mergers Sens.
Kairi Pangelinan
In the wake of a hospital merger, several personnel groups are affected, including clinical
staff, administrative staff, support services, and medical staff. Each group faces unique
challenges as they adapt to new protocols, systems, and cultural norms. Merging cultures
involves blending different operational practices, decision-making styles, and communication
methods, which can lead to resistance, decreased morale, and changes in governance that affect
job satisfaction and performance. Changes in leadership and management structures often create
uncertainty and affect staff morale.
To address these challenges, developing a comprehensive integration strategy that
includes clear communication, training programs, and opportunities for feedback is crucial.
Creating a unified culture that combines the strengths of both organizations can help ease the
transition by involving staff in the decision-making process, recognizing and rewarding
contributions, and fostering a sense of shared purpose. Effective negotiation strategies, focusing
on interests rather than positions, active listening, empathy, and transparent communication are
essential to securing buy-in. A trusted leader should convey the vision, benefits, expected
changes, and support available to staff, ensuring consistent and open communication to
demonstrate the merger's positive impact on patient care, quality, safety, cost of services, and
access to care. By employing these strategies and leveraging best practices, the merged
organization can achieve a successful integration and foster a cohesive, collaborative work
environment. 14
Based on group discussions and feedback, I would consider modifying certain aspects of
my strategy. One key modification would be the incorporation of personalized communication
strategies. The feedback highlighted the necessity of tailoring messages to different stakeholder
groups to address their specific concerns and needs more effectively. For instance, clinical staff
might require detailed briefings on new clinical protocols, while administrative staff might need
information on changes in governance and operational practices. By customizing
communication, the strategy can better resonate with each group, fostering greater understanding
and acceptance.
Another modification would be to place a stronger emphasis on leadership training and
support. The group discussions revealed that leaders might struggle with the changes themselves
and require additional support to navigate the transition effectively. Therefore, specialized
leadership training programs should be included to equip leaders with the necessary skills and
knowledge to guide their teams through the merger. This approach would ensure that leaders are
well-prepared to model the desired behaviors and support their staff.
If I alone could decide on a solution following discussions with my group, I would
combine the initial strategy with the modifications suggested by the feedback. The enhanced
communication plan would implement a multi-tiered approach that includes both general updates
and tailored messages for specific stakeholder groups. Regular town hall meetings, newsletters,
and digital platforms would be complemented by personalized briefings and Q&A sessions for
different departments. This strategy would ensure that all employees are well-informed and
engaged. Specialized training programs would be developed not only for clinical protocols and
operational practices but also for leadership. These programs would equip leaders with the skills
and knowledge needed to support their teams effectively during the transition. Leadership 15
alignment and collaborative workshops would be emphasized, ensuring that leaders are
synchronized on core values and strategic priorities. Robust feedback mechanisms would be
implemented to gather input from employees and make necessary adjustments. Regular surveys,
suggestion boxes, and open-door policies would be utilized to maintain an ongoing dialogue with
staff. This approach would ensure that potential issues are identified early and addressed
promptly.
Defining and communicating clear roles and responsibilities for all employees during the
integration process would prevent confusion and ensure that everyone understands their part in
the new organizational structure. This comprehensive approach would ensure that all aspects of
the merger are addressed, fostering a smooth integration and creating a unified, effective
organization. By employing these strategies and leveraging best practices, the merged
organization can achieve a successful integration, optimize patient care, and foster a cohesive
and collaborative work environment. This balanced approach ensures that all employee groups
are considered, leading to a stronger, more cohesive organization post-merger.
