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Frontiers in Public Health, 2021
Job satisfaction plays an important role in healthcare organization and management; it is critical for maintaining and improving staff efficiency and consequently the quality of care provided. Organizational restructuring processes, including mergers, are likely to affect job satisfaction levels, but evidence of the impact they have is surprisingly scarce. The aim of the study was to describe a methodology used to measure job satisfaction of the employees at a Local Health Unit (LHU) in Italy immediately after a merger and to assess the determinants associated with any reduction in worker satisfaction. The study was conducted among employees of the LHU of the Sardinia Region in July 2018, after a merger of eight subregional LHUs had taken place. The entire staff was enrolled, of which a total of 1,737 employees were surveyed. We used a questionnaire exploring socio-demographic and working characteristics of the employees, the various areas related to job satisfaction and interviewee...
How is the Firm Dealing with the Merger? A Study of Employee Satisfaction with the Change Process
Journal of Management and Strategy, 2011
The purpose of this study was to understand the degree to which employees' satisfaction with merger-induced organizational changes impact on their productivity and the merged-firm performance. This is because, the introduction of market-driven business reforms in many developing economies has seen the emergence of growth-drivers that includes the search for new markets, increasing competition in local markets, new investors' interest in emerging markets, and hence the desire for firms to merge. The results showed that human resource issues are important aspects of mergers which, if it is not well handled, may impact negatively on employee satisfaction with consequent repercussions on productivity and the success of the merger. It is concluded that employee satisfaction to a merger-induced organizational changes could be enhanced by instituting effective two way communication system and using participatory approaches in job redesign processes. By implication, merger-induced change has human factor challenges that merging firms need to understand.
Patient Satisfaction and Merging of Small Hospital
The Professional Medical Journal
Background: The first merging of small hospitals into a large one came into existence in January 2005 in county Louth. As a result the surgical departments of Louth county hospital Dundalk and Our lady of Lourdes hospital Drogheda Ireland were combined. Two hospitals are at less than half an hour drive and situated North-eastern region of Ireland. Objectives: To assess the impact of joining two departments of surgery in two different hospitals along with the patient’s reaction after such arrangements were made. Design: review of literature. Setting: Louth County Hospital Dundalk Ireland. Period: One year Methods: Following review of literature it was decided to explore the experience of patients who were treated in Louth County Hospital Dundalk one year after merging of two departments of surgery. Randomly 20% of patients treated in Louth County Hospital were included in a telephone survey. These patients were under care of all consultant surgeons. The patients were asked about thei...
Executive management in radical change—The case of the Karolinska University Hospital merger
Scandinavian Journal of Management, 2011
Introduction. Today there is no doubt that mergers have permeated all sectors of society, including health care. Starting in the US, extensive waves of hospital mergers occurred at a record pace in the 1980's typically justified by promising dramatic financial and operational improvements. In the 1990's, the merger trend reached Europe and by the turn of the century "merger mania" had taken a strong hold within the UK. By the end of the 1990s, there had been a number of hospital mergers in Sweden. In 2004, Karolinska University Hospital was formed through the flagship merger between the Karolinska Hospital and the Huddinge University Hospital. In 2010, yet another prestigious merger of two university hospitals was announced with the formation of Skåne University Hospital. However, there has been almost no research on hospital mergers in Sweden. The aim of this thesis is to increase our understanding of the pitfalls and possibilities in merger processes by exploring the Karolinska University Hospital merger. The merger in brief. On 1 January 2004, the Karolinska Hospital and the Huddinge University Hospital merged to form the Karolinska University Hospital. Although the merger was controversial and far from obvious, the merger decision passed by a single vote in the Stockholm County Council on 9 December 2003. To achieve a balanced budget by the next political election in 2006, the new director of the merged hospital was told to reduce expenditures by €70 million over the next three years. The top management delegated identical assignments to all clinical managers: to reduce costs and to consolidate 125 clinical departments into 74 new departments each with a common management. Over the three-year period (2004 to 2006), the predicted cost savings for the merger were not achieved. Eventually the original implementation plan was withdrawn and the hospital director left the organization. Methodology and research questions. An embedded case study design was used to explore pre-and post-merger processes, in which data was collected by interviews, non-participant observation and extensive documents (allowing triangulation). Three studies addressing different organisational levels examined the following issues: how and why a merger decision that was considered "impossible" became possible (Study I); how and why top management's radical ambitions resulted in an unintended convergent process and dysfunctional outcomes (Study II); how and why considerably different outcomes in terms of clinical integration occurred at the clinical department level (Study III). Results. Spanning from the years 1995 to 2007, the three studies show that the merger processes evolved through a non-linear, undirected and complex interplay between external and internal actors. The process was mainly driven by the competing institutional logics of managerialism in a political and administrative arena, and professionalism in a scientific and professional arena. Means convergence and a politico-economic crisis led to the merger decision. The top management was overwhelmed by the "vertical clash" between managerialism and professionalism. On the clinical department level, managerial factors that hindered integration were a sole attention on the formal mandate from the top management, leadership based on one formal actor, and the use of a planned top-down approach to change. Managerial factors that facilitated integration were a dual attention to two majors stakeholders (top management and clinical staff), shared leadership between multiple actors, including an informal leader, and the use of an emergent, bottom-up management approach to change within the planned assignment. Discussion. The key finding is that the competing institutional logics between managerialism and professionalism seems to be the main driver of merger processes. This vertical conflict is probably the main explanation why intended outcomes were not achieved. While top management followed the merger literature's classic recommendation to focus on the horizontal tension and to take a planned linear top-down approach to change, the unanticipated challenge stemming from the competing institutional logics made it difficult for the management to handle the post-merger process. A true understanding of the intra-and inter dynamics inherent in a context with multiple layers of competing institutional logics, such as public sector health care, seems essential to produce functional organizational outcomes.
2021
Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.
Hospital Reorganization After Merger
MEDICAL CARE, 1995
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. This content downloaded from 128.255.6.125 on MonMajor organizational changes among hospitals, like system affiliation, merger, and closure, would seem to offer substantial opportunities for hospitals and health systems to be strategic in the local reconfiguration of health services. This report presents the results of a unique survey on what happened to hospitals after mergers occurring between 1983 and 1988, inclusive. Building on an ongoing verification process of the American Hospital Association, surviving institutions from all 74 mergers that occurred during the study frame were surveyed in the fall of 1991. Responses were received from 60 of the 74 mergers (81%), regarding the primary, postmerger use of the hospitals involved. Topics surveyed included the premerger competition between the hospitals and in their environment, and what happened to the hospitals after their mergers. Mergers frequently served to convert acute, inpatient capacity to other functions, with less than half of acquired hospitals continuing acute services after merger. In the context of health care reform, mergers may offer an expeditious way locally to restructure health services. Evidence on the postmerger uses of hospitals and about the reasons given for merger suggests that mergers may reflect two general strategies: elimination of direct acute competitors or expansion of acute care networks.
A cross method analysis of the impact of culture and communications upon a health care merger
Journal of Management Development, 2003
The incidence of mergers and acquisitions has proliferated throughout the world including all sectors of our society, both municipal and industrial, private and public. However, the majority (60‐80 percent) of them do not reach their intended objectives owing to the fact that the merging organizations do not realize the impact of neglecting the human resource factor. Although they properly assess and address the financial and legal issues, they continually overlook this critical factor. The present literature suggests what organizations should do to reverse these negative effects and how to properly address the human resources issues. This research seeks to test this list of suggestions, in the form of a unified model, employing the single case study method. The case in question is a newly merged health centre comprised of four well‐established hospitals. Rather than a set of hypotheses, sets of prescriptions were developed to test the model. Data from interviews and existing docume...
The bigger, the better? A systematic review on the impact of mergers on primary care organizations
European Journal of Public Health, 2021
Background Primary care services are the first point of contact in a healthcare system; in the last years, many mergers and reconfigurations have taken place in this setting. The aim of this study is to summarize the literature evidence on the relationship between the increase in the size of these organizations and their performance. Methods A systematic review of the literature was carried out querying EMBASE, MEDLINE and Web of Science databases, from their inception to January 2020. Articles which quantitatively assessed outcomes and process indicators of merger/structural reorganization of primary care organizations and qualitative articles that assessed staff perception and satisfaction were included in the review. Results A total of 3626 articles was identified and another study was retrieved through snowball search; 11 studies were included in the systematic review. Studies about lipid profile evaluation and emergency admissions for chronic conditions showed moderate evidence...