Hospital merger analysis and strategic outcomes

John Hopkins Hospital Merger

The Perspective of Human Resources

The purpose of this work is pertaining to the acquisition of a hospital that provided service to a limited community within the region served by John Hopkins (JH). The larger unit, JH has all its departments and functions fully managed with an executive vice president as the head of the unit. Included are VPs of Finance, Information Systems, Administration, Compliance, Employment Services provided so there would be no need to retain all the staff of the community hospital. Due to the acquisition the community hospital would be delegated as a department within the JH organization and the previous CEO has been named executive VP who will report to the CAO of JH. The board of JH determined that it would not be cost effective to maintain any of the employees of the community hospital.

Reassignment must be accomplished in relation to filling the positions of nurses, doctors, and support staff for the purpose of full maintenance of all services at the community hospital. Staff is comprised of approximately 3,000 employees. The management at JH felt that with efficient assignment of staff that it could operate the community hospital profitably and prevent any potential layoff of its own staff. This was a concern since the community hospital has significant debt that JH is required through the terms of acquisition to settle. Furthermore JH had problems itself in the maintenance of cost and had considered laying-off staff. This absorption of debt would place JH in fiscal jeopardy of some type were financial affairs not efficiently managed.

The decision has been made by management to restructure the use of staff to ensure that all abilities are fully utilized. The staff's morale was negatively affected by this decision. As stated in the article of James Hauden and Donald MacLean:

the purpose of change management is not to create a great change management plan...it is to engage people in your business so they can think and act differently about it...all the people in the company must realize how they must personally change at a deep intrinsic level to make the transformation a reality. (Hauden & MacLean, 2002)

If JH wants to change to be a success then John Hopkins must, through HR change management take the lead and show that they are willing to sacrifice and will require the staff to do likewise. This work will address the following from the above change initiation which is a hospital merger.

Supervisory training - What (new) skills will managers and supervisors need after the change is implemented? Why? What (new) skills will managers and supervisors need after the change is implemented? Why? How will they obtain these skills and competencies?

Employees relations policies and procedures - What, if any HR policies and procedures will need to be implemented/changed? Why? What are implications of not changing these policies and procedures?

Develop action steps, responsibilities, due dates, deliverables and so on, for each planned intervention.

Organization - Are there clear lines of responsibility for all activities, including the role of HR?

Introduction

How-to-guide entitled "Managing Organizational Change" written by Queensland Health in 1998 advises manager on the planning phase of organizational change in relation to the planning and implementation. The reaction of the staff within the organization to the process of change greatly influences the success of the change and the outcomes of the organization's management initiative. Therefore, the emotional aspects of the employees and the resulting interactions are something that the manager must calculate in the change management planning equation. It is vital that the employees of the institution or organization possess 'ownership' in the upcoming changes. It is up to the manager to see that this takes place through appropriate equitable processes...that focus on the need for constant open communication with employees and their representatives." (Queensland Health, 2005)

Upon having determined that change management will take place the realization that "variables are predictable and can be allowed for in the planning process, whereas other variables are difficult to predict or include in the plan." Three listed 'keys' in changing paths within an organization are stated to be:

The path of change as planned by the change agent to achieve the future state.

The status quo, which is predicted to (or already does), produced an undesirable future state.

The actual path of change initiated by timely directors of the manager is the course of achieving the current state.

In change management initiatives that failed the following were cited as reasons for lack of success in the organizational change process:

1. Managers who were unwilling to assign the needed resources to the project or would not allow their representative adequate time to participate

2. Managers who filtered out important messages or started negative conversations about the change

3. Employees who became distracted and lost interest in their current work responsibilities thereby impacting overall productivity and customers

4. Valued employees who left the organization

5. More people taking sick leave or not showing up for work

6. Unforeseen obstacles to the change that seemingly appeared from nowhere

7. A lack of funding for the change (Hiatt & Creasey, 2005)

Supporting Employees through the Organizational Change

Critical in the success of change is the establishment of communication and consultation processes. This is accomplished through providing information on changing policy, planning management strategies for service delivery. Included is employee representation in the design, implementation and evaluation stages, as well as the provision of training to enable employee representatives to contribute to the process and providing training to representatives of the employee group for contribution to the process. To effectively match employee skills to the new units of work it is vital to have a record of employee skills that is accurate therefore a skills analysis of each employee is critical. The provision of employees training for meeting the requirements of new roles in the organization is very important and requires providing "targeted training and development to assist them to perform effectively. Further stated is the advice that "managers factor training and development issues into the plan at the earliest possible stage. Training should be formulated from the skills analysis and the development of objectives and specifications to guide trainers to prepare and deliver training programs. Employee participation in the organizational change will effectively ease the tensions as well as the inherent fear of the change process.

Development of Action Steps

Vital in the process of change is the development of clear and concise steps of action that are required to be taken and further the supervisory enforcement of each step to be taken. The reason for this enforcement is the necessity of a well-laid plan being followed because without a carefully structured process the change of management will quickly become a scene of chaos and possibly one of disaster.