Collaborative Assignment Reflection
The future of healthcare organizations and systems is uncertain, considering the dynamics in economic issues, competition, legal and policy landscapes, technological advances, workforce scarcity, and consumer demands. Amidst these unprecedented issues, hospitals consider mergers and acquisitions as ideal strategies for increasing their market share, gaining new capabilities and diversifying the capacity and mechanisms for service delivery.
According to Mariani et al. (2022), hospital mergers involve the dissolution of one hospital and its subsequent absorption by a more powerful hospital. Although mergers result in financial, structural, and procedural benefits, merging two formally independent health organizations is risky, considering the complexities of harmonizing two institutional cultures, the likelihood of creating power struggles, employee dissatisfaction, and the overall disruption of workflows.
As a high-level executive officer at Baptist Hospital of Miami contemplating the imminent merging with a group of medical centers, I must develop and devise approaches to address the potential issues and pushbacks, including challenges in merging the two cultures.
The Personnel Groups Affected by the Merger
Although the imminent merging with a group of medical centers would affect all organizational stakeholders, the merger syndrome is more significant and conspicuous among employees, including the clinical and medical staff. According to Chesley (2020), employees demonstrate resistance to change, feelings of job insecurity, reduced job performance, culture shock, and fear toward mergers, especially when effective communication patterns and systems are lacking.
In the context of a merger between the Baptist Hospital and the group medical centers, it is essential to enhance employees’ understanding of the potential benefits of mergers and guarantee their job security to address merger syndrome.
Challenges in Merging the Two Cultures
Mergers between two or more hospitals prompt massive transformations and alterations of organizational cultures. Chesley (2020) defines organizational culture as “an accumulation of experiences among those who participate in the organization” (p. 137). A successful merger entails the effective sharing of cultural attributes of the two organizations, a complex process, considering employee uncertainty, resistance to impending change, high employee turnover, and potential power-sharing issues.
Further, merging two cultures is uncertain due to incompatible practices, the likelihood of a lack of collaboration between the two merging systems, employee dissatisfaction, job insecurity, and the imminent disruption of norms, practices, and behaviors that constitute the institutional culture.
Strategies and Solutions to Address those Challenges
It is possible to address challenges in merging two cultures by ensuring effective communication and negotiating different perspectives and ideas. According to Cerezo-Espinosa de Los Monteros et al. (2021), a merger process results in uncertainties among employees, prompting leaders to embrace collaborative conversations and consensus decisions to obtain feedback from staff members and other stakeholders.
Collaborative conversations and negotiation enable leaders and employees to discuss the mission and vision for the healthcare system, appreciate the rationale for merging, and comprehend the financial, procedural, and structural benefits of merging with a group of medical centers.
The Negotiation Strategies Useful to Elicit Buy-in on the Decision
Negotiation entails bargaining and considering options to realize win-win outcomes. Stakeholders, especially clinical and medical staff, can exhibit varying opinions and standpoints during a merger. These different perspectives, ideas, and thoughts can manifest as restraining factors for change, fear, and job insecurity. According to Clay-Williams et al. (2018), the best mediation strategy for achieving win-win outcomes is the collaborative negotiating style.
This approach reflects the high importance of outcomes and a significant concern for interprofessional relationships. While applying this negotiation strategy, both parties must get what they need while enhancing the relationship (Clay-Williams et al., 2018). The plausibility of achieving a win-win outcome elicits buy-in on the decision and is vital in addressing the restraining factors for change.
Mode of Communication to Convey these Strategies to the Clinical and Medical Staff
Organizational leaders, including the chief executive officers (CEOs) and the heads of human resource departments, should be the primary communicators because they have adequate information regarding the merging process. They should enlighten other stakeholders, especially clinical and medical staff, about the imminent changes in leadership structures, infrastructure, procedures, and organizational culture due to the imminent merging with other medical centers.
Primary communicators should use a collaborative, bottom-up, two-way communication model to convey information about the merging processes. According to Cerezo-Espinosa de Los Monteros et al. (2021), relevant and timely information exchange, involving stakeholders in decisions, and strengthening intermediate managers’ roles in decision-making can improve communication.
Stakeholders should access timely and accurate information regarding the organizational and structural characteristics of the organization, competitive issues, job security, and economic factors surrounding the merging decisions.
Besides effective communication and interactive conversations, it is essential to obtain stakeholder buy-in by defining and sharing the mission with the entire organization, empowering employees by cultivating behaviors and characteristics that support the merger, recognizing team members, and demonstrating gratitude to employees by safeguarding their jobs and creating a sense of stability amidst the imminent merger.
The imminent merger between the Baptist Hospital of Miami and a group of medical centers is a landmark decision that impacts the hospital’s financial, infrastructure, and market landscapes. Although the Baptist Hospital of Miami is a reputable healthcare organization with 453 beds and multiple services, it is vital to enhance the hospital’s capacity to provide various services, including comprehensive care programs, cardiovascular services, robotic surgery, and outpatient services.
Mariani et al. (2022) contend that different drivers motivate healthcare organizations to merge with others. For example, mergers in the United Kingdom (UK) are primarily for political decisions, while in the United States as are market-driven and entrepreneurial.
In the case of the Baptist Hospital of Miami, the primary drivers of merging with other medical centers include the need to compete effectively with other healthcare systems, the determination to increase market share, and the overarching objective of improving the integration of advanced technologies into nursing practice.
Decision-Making and Negotiation Approaches Defined in the Proposal
After reviewing the current research on effective decision-making and negotiation approaches during mergers and acquisitions, many studies supported collaborative practices and interactive conversations as profound interventions for eliminating challenges facing stakeholders during hospital mergers.
Mariani et al. (2022) argue that mergers can lead to outcome relationships, service consolidation, and improved care quality. However, policy and decision-makers should establish a clear vision and encourage a continuous appraisal of benefits and drawbacks before making the merging decision.
Chesley (2020) identifies cultural shock, reduced job performance, resistance to change, job insecurity, and a general feeling of fear associated with the imminent changes in the organization’s culture. As an organizational leader, I am responsible for negotiating different perspectives, considering a diversity of ideas, and obtaining buy-in through timely and effective communication. These approaches prompt collaborative and team-based decision-making and negotiation approaches.
Facilitation and Negotiation Strategies
In my professional life, I would use interactive and collaborative facilitation and negotiation strategies to obtain stakeholder buy-in, especially when implementing quality improvement and change initiatives. These strategies focus on achieving a solution where everyone benefits and reflecting high importance on the outcome. As a leader, I should create additional value as part of the negotiation by allowing all parties to air their concerns and find ways to get what they need while enhancing interprofessional relationships.
Cerezo-Espinosa de los Monteros, J., Castro-Torres, A., Gómez-Salgado, J., Fagundo-Rivera, J., Gómez-Salgado, C., & Coronado-Vázquez, V. (2021). Administration of strategic agreements in public hospitals: Considerations to enhance the quality and sustainability of mergers and acquisitions. International Journal of Environmental Research and Public Health, 18(8), 4051. https://doi.org/10.3390/ijerph18084051
Chesley, C. G. (2020). Merging cultures. Journal of Healthcare Management, 65(2), 135–150. https://doi.org/10.1097/jhm-d-18-00213
Clay-Williams, R., Johnson, A., Lane, P., Li, Z., Camilleri, L., Winata, T., & Klug, M. (2018). Collaboration in a competitive healthcare system: Negotiation 101 for clinicians. Journal of Health Organization and Management, 32(2), 263–278. https://doi.org/10.1108/jhom-12-2017-0333
Mariani, M., Sisti, L. G., Isonne, C., Nardi, A., Mete, R., Ricciardi, W., Villari, P., De Vito, C., & Damiani, G. (2022). Impact of hospital mergers: A systematic review focusing on healthcare quality measures. European Journal of Public Health. https://doi.org/10.1093/eurpub/ckac002