1. Section Editor(s): Hader, Richard PhD, NE-BC, RN, CHE, CPHQ, FAAN

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Don't be surprised if you walk into work one day and your hospital's CEO announces that you're merging with or being acquired by another hospital or health network. Over 50% of the hospitals in the country have either merged, been bought by for-profit corporations, or have some type of financial agreement with another organization. It's becoming increasingly difficult for independent hospitals to survive the economic challenges without a partner. Although many board members and administrative staff don't want to give up their independence, they find themselves partnering with financially stable organizations because they can no longer survive on their own.

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Recent healthcare legislation and the rapid proliferation of accountable care organizations have prompted healthcare leaders to strategically analyze current economic performance and begin to forecast future business growth opportunities. For many hospitals, the projected results demonstrate that economic and infrastructure needs require sharing of resources to reduce costs. The development of clinical networks, which includes primary and specialty care integration, will need to be supported by healthcare systems to provide the full continuum of services.


When healthcare organizations merge, they're often in a better position to negotiate fees from vendors and payers. This is becoming increasingly important for hospitals to provide quality products and services at an appropriate cost. Multihospital systems that care for a larger percentage of the population have a much better opportunity to stay (or become) financially solvent.


As hospitals begin to merge at an increasingly rapid pace, they often become part of large corporations. If merged organizations aren't led and managed appropriately, it can have a devastating impact on the team members who work for the hospital and the community it has traditionally served. Team members who've worked for an organization for many years will often be faced with countless changes, from wages, hours, and working conditions to new policies and procedures. Most of these tactical issues will be resolved over time, but the primary issue-and the most difficult to resolve-is the change in culture.


Many organizations have similar clinical guidelines and protocols, but all have different cultures. The merging of cultures will be much more difficult than merging financial statements or negotiating vendor contracts. The culture of an organization is often deeply ingrained and must be respected and acknowledged for its values, systems, and beliefs. Although numerous systems and processes will need to be changed, core values should be ignited and the search for similarities accentuated.


Merging facilities shouldn't thwart creativity-it should inspire it! Open dialogue between newly merged partners should spark ideas to best meet the needs of patients. If done correctly, administrative and operational changes will focus on improving patient care for the benefit of all.


Be prepared to join forces with your colleagues and accept a merger as an opportunity, not a threat!



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