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ID-10093552-healthcare-consolidation-cultureConsolidation of hospitals and health systems may have hit an all-time high as health reform and market forces continue to drive mergers and acquisitions. It is important for healthcare organizations to address the cultures that exist in different facilities during the consolidation process. There is a clear relationship between the culture of an organization and its performance. The norms, values and beliefs of culture also have a big impact on behaviors that support, or do not support, a safe environment in which to provide patient care.

The time to begin assessing organizational culture begins with the due diligence process. In addition to looking at financials, facilities and properties, bylaws, human resources, insurance, etc., there is an opportunity to assess vision and strategy, overall corporate culture and, more specifically, safety culture. Leaders should begin planning to merge cultures as early as they plan to merge finances and assets. If they fail to do so, conflicting cultures can, at best, delay a successful merger and, at worst, contribute to a work environment that is unsafe and unreliable. This has implications for the patients receiving healthcare services, as well as the providers and staff delivering them.

A central question to ask is, “What culture do we need to achieve the goals of our merged healthcare organization?” Many organizations seek to implement a culture of respect, one that is safe, and fosters learning and growth. Once identified, leadership must support the creation of that culture. The following steps can help shape the desired culture:

  1. Start with a baseline. Collect the most recent employee and provider satisfaction surveys, patient experience of care surveys and culture of safety surveys for the organizations being consolidated. The results may be very different for each one. Lean what’s best about each one and what needs improvement. Understanding the current state is key to setting goals for the desired future state.
  2. Plan to create the “consolidated” culture. Engage clinical leaders, executives and managers in planning for culture change with alignment of mission and vision. Some organizations hold an offsite retreat for this process. Identify approaches for communicating expectations, modeling behaviors and celebrating successes.
  3. Employ relationship management. Use leadership walkrounds or other forums to build trust. Talk to providers and staff at various levels in the merged organization, gain their perspective, involve them in planning and reinforce their commitment to the organization.
  4. Implement culture change strategies. Leaders and managers must be relentless in communicating and reinforcing the message about the vision for the merged organization’s culture. Allow for flexibility in meeting established goals. Provide rewards in the form of approval and recognition – honor those exemplifying the values being shaped and the culture being melded.

Planning to address organizational culture early on in the merger and acquisition process can mean the difference between thriving in the new world of healthcare and merely surviving in it.

Kathy Shostek, RN, ARM, FASHRM, CPHRM, CPPS, Sr. Healthcare Risk Management Consultant

 

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