Introduction
Most hospitals today face the challenge of limited resources and as such, seek to increase their chances of survival by minimizing duplication and improving efficiency especially by forming mergers and consolidations (Anderson, 1991). Additionally, increased competition due to prospective payment system is yet another factor that compels hospitals to merge their operations for a common goal. In any case, mergers play significant role of ensuring that professional services are rendered, efficient patient care activities are given, and proper management is conducted. Besides, mergers generate a culture whereby merged entities gain full control of all the activities taking place in the hospital and make great sales. However, mergers can affect hospital operations. The diverse operations that can be affected include staffing, efficiency and operating practices. It can also affect the performance of workers as expounded in the essay especially if merging hospitals were initially rival competitors. This may put managers in a hard-hitting position of ensuring that working behavior is thoroughly controlled after the process of merging. On the same note, it is commonplace to witness workers change their attitudes at workplace especially after two organizations merge. In fact, some of them may be disgruntled or completely uncontrollable. This essay will examine impacts of mergers on sales and efficiency in performance of workers with cross reference to a hospital setting.
Impacts of sale on the culture of the newly combined organization
As already mentioned, most hospitals today face managerial difficulties on how to harness limited resources which may be both human capital and financial resources. Hence, they seek to increase survival chances by reduce duplication, improving efficiency and overcoming competition and other exogenous pressures through mergers and consolidations (Anderson, 1991). The rationale behind such an initiative is to effectively compete in health care market. To say the least, it is imperative to note that merger of hospitals improve operating efficiency thereby effecting growth in terms of sales. On the same note, the market power gained by merged hospitals is higher than that of individual healthcare unit. In this case, a poor performing hospital joined with a better performing partner will gain in terms of sale by pooling their resources and skills together. This also will be attributed to one of the partner’s management expertise. Additionally, since the merged hospitals were previously in competition, their market power could have been high. Therefore, the impact on sales after merging is highly likely to be higher in addition to the fact that overlapping of services being offered by both partners is likely to be experienced.
Roles of a middle manager in ensuring that the combined staff works together to provide quality care without taking on a competitive stance
Mergers, as already examined, may affect the level of performance of a hospital. Due to myriad of difficulties that may arise in key primary operational areas, quality of service rendered by the staff of a merged hospital may be affected. This calls for middle level managers to play critical role of ensuring that the integrated and combined staff work as a unit to give quality services despite their differences (Smith, 2001). It is instructive to understand that operating efficiency, personnel practices and scale of operations of staff are strained when they are merged owing to their different backgrounds. According to Smith (2001), Peter Senge, a strategist, indicates that managers should play the role of ensuring that there is learning in their organizations. He observes that this is significant where individuals intend to achieve a common goal, have collective aspirations and expansive thinking patterns (Smith, 2001). In this sense, a middle manager in a merger should create awareness to the staff on the importance of being productive, adaptive and flexible when working together, as this is vital for organizational success.
As earlier discussed, when mergers are incompatible due to asymmetry or dissimilarity in size, members of staff may find themselves in a non-conducive environment where there is unequal distribution of power and a competitive attitude (Cameron, Este & Worthington, 2010). The latter can be as a result of competition in offering health care services prior to merging. Staff members may carry that attitude into a merged organization. Therefore, there is need for a middle manager to apply basic principles of guiding and directing entire workforce on the importance of team work and group dynamics. This may be achieved through team learning, developing shared vision, creating mental models, personal mastery and systems thinking (Smith, 2001). The latter is essential in uniting staff by focusing on a long-term view. Moreover, a middle level manager should seek solution to existing differences among workers by understanding that change is a dynamic process. This will prompt managers to devise strategies that will provide long term improvement in healthcare.
Additionally, mental models can be used to foster changes and develop new orientations among members of staff. A manager should encourage openness among working staff, retain control and coordination as well as distribute roles responsibly (Smith, 2001). Furthermore, the difference existing among the merged staff can be overcome when a manager creates a common goal for an organization. According to Smith (2010), a staff that has shared and common goals has the capacity to work together. Such a goal creates a sense of long-term responsibility to the staff. It is important to note that goals encourage teamwork, innovation and experimentation.
How the organization will look like in terms of system and shape
A hospital merger is shaped when one or two hospitals that are independent coalesce with another either through absorption of a dissolved hospital or when participating hospitals dissolve to create a new one. According to research studies, there are two significant causes of hospital mergers. The causes include the need to form a first-class management base, and to achieve a requisite investment. When hospitals merge, their systems and shape changes. Some of the developments that take place in its system include a new and specialized technical staff, an augmented support to attain desired clinical services, heightened market shares and ability to acquire technology that is cost effective (Anderson, 1991). A merger entails full integration and combination of resources of merging hospitals. Theoretically, this impacts heavily on the shape and system of an organization in terms of augmentation and performance. Even though mergers are significant in rendering professional services, patient care activities, management and support services, it is instructive to comprehend that it affects the system of activities in hospitals (Morgan et al., 2010). Such areas include staffing, efficiency as well as scale of operations.
The preliminary stage of merging hospitals involves legally joining the staff and other resources. Even though the management may perhaps set up strategies and measures to protect activities, subgroups and individuals, issues such as a competitive attitude and rivalry that existed prior to merging may be a constraint to achieving efficient services and integration (Anderson, 1991). However, it is imperative to observe that the practice that involves integrating two formerly independent hospitals that were previously competitors affects the system of the hospital in terms of coordination, communication, strategic direction and corporate culture. Additionally, cases of discrepancies and dissimilarity in interest are some of the issues that are bound to arise within a merger.
Implementing changes in the merged system and shaping the organization in terms of staffing, staffing practices and operations may be cumbersome. This can be attributed to the time period of formation, similarity in ownership and dissimilarity in size of the merged hospitals. The latter is a common cause of unequal power distribution between the merged hospitals (Anderson, 1991). When size is asymmetrical, the powerful one will be in command of the operation system of the entire hospital by exercising greater leverage. As a result, the other party in a merger may effectively resist that kind of operating practice. Such an organization will show indications of difficulty in bringing integrative changes in its system. Dissimilarity in size might also be seen in the total number of personnel, average number of nurses per daily census and increased number of beds. It is instructive to note that this affects staffing and capacity practices. In a situation where there is a similarity in ownership, the system of operation will be conducive. It will be easier to orientate strategies, missions and cultures. Additionally, carrying out operational changes, motivating and integrating workers to effect operations will be possible.
The systems of a merged hospital will work effectively towards achieving of a common goal if they are compatible (Anderson, 1991). This will make it easy for them to implement new changes. Conversely, without compatibility between the staff and the operating systems due to enmity or competition, instances of greater resistance to changes and other disparities will affect performance, and this will require more energy and time to resolve.
Conclusion
To sum up, this study examined various changes and cultural practices that may be observed when hospitals that were previously competing, and of dissimilar strengths and quality, merge. As indicated in the body of the text, primary areas affected by such mergers include staffing, efficiency and operating practices. Initiating changes in these areas and having the staff working together despite their differences is inhibited by factors such as merger period, ownership similarity and size similarity and/or differences. This calls for setting up of strategies and measures to cope with emerging and inevitable challenges. A middle manager therefore, has a role of ensuring that the entire workforce pulls together as a team in attaining common goal. This can be achieved through organizational learning through which middle level managers play integral role a role of initiating team learning, creating shared vision as well as mental models. It is also worth to mention that while mergers among formerly competing organizations may prove to be quite a challenge both in terms of harmonizing managerial competences and developing common thinking among workers, the initiative may widen opportunity for further profitable ventures bearing in mind that each partner will inject new ideas into the newly formed organization. Definitely, the overall performance of the merger is highly likely to be higher than operations of a single entity.
References
Anderson, H. J. (1991). Hospitals Face Tough Issues in Years Following Mergers. Hospitals 65 (18), 24-32.
Cameron, P. J., Este, D. C. & Worthington, C. A. (2010). Canadian Journal of Public Health 101(1), 79-82.
Morgan, G. B. et al. (2010). Job Satisfaction in the Home Health Care Context: Validating a Customized Instrument for Application/Practitioner application. Journal of Healthcare Management, 55(1), 11-24.
Smith, M. K. (2001). Peter Senge and the learning organization. Web.