Mergers involving academic medical institutions: Impact on academic radiology departments

Helsefeltets strateger

“…Although this study revealed that the obstruction by the professionals impeded clinical integration, many traditional merger studies on hospital mergers have continued to argue that horizontal tensions, clashes and other hindering factors between the merging organizations are the main reasons behind hospital merger failures. In similar way, the results from studies of university hospital mergers in the US are somewhat patchy as they place the horizontal tension in the centre (Kastor, 2003;Cohen & Jennings, 2005), at the same time as they report the importance of the conflict between economic, medical and academic logics that obstruct integration (Kastor, 2003).…”

“…However, in a more recent study, Kastor (2010b) attributes the main reason for university hospital merger failure (such as Mount Sinai-NYU Health System and UCSF/Stanford) to the "horizontal" tensions, clashes and oppositions existing at different levels of the faculties, medical school, senior leadership and trustees of the merging organizations. His focus on horizontal differences is in line with a review of over a dozen university hospital mergers where each merger included at least one AHC (Cohen & Jennings, 2005). Cohen and Jennings (2005: 176) even suggest "perhaps the dominant reason for merger failure is cultural incompatibility between the two organizations" (see also Shaw, 2003).…”

“…These actions are consistent with the normative literature that advocates the necessity of addressing horizontal cultural differences at an early stage (Datta, 1991;Sales & Mirvis, 1984). Studies of university hospital mergers have also found that a main reason for failure may be attributed to horizontal tensions and clashes between top management and trustees at early stages (Cohen & Jennings, 2005;Kastor, 2003Kastor, , 2010b. However, although the research claims that horizontal integration of top management is necessary for overcoming resistance between the merging organizations at later stages (Santala, 1996, Schriber, 2006, such integration may be insufficient, as explained next.…”

“…Fulop et al, 2002: 5). For example, the tendency for one management team to dominate the other is mentioned as an early "horizontal" tension that may impede intended change at later stages (Cohen & Jennings, 2005;Fulop et al, 2002;Kastor, 2003).…”

“…Research generally shows that rapid consolidation of nonclinical departments (i.e. administrative functions) with single leadership appointments were achieved early on, but that clinical integration stalled (Cohen & Jennings, 2005;Kastor, 2003). In addition, Kastor (2003) also find considerable integration of educational activities in successfully merging hospitals.…”