Organisational culture and post-merger integration in an academic health centre: a mixed-methods study

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• 作者：Pavel V Ovseiko (1)
  Karen Melham (2) (3)
  Jan Fowler (4)
  Alastair M Buchan (1) (5)
  
  1. Medical Sciences Division ; University of Oxford ; John Radcliffe Hospital ; OX3 9DU ; Oxford ; UK
  2. Centre for Health Law and Emerging Technologies (HeLEX) ; Department of Population Health ; University of Oxford ; Oxford ; UK
  3. Research Services ; University of Oxford ; Oxford ; UK
  4. NHS England ; Thames Valley ; UK
  5. Oxford University Hospitals NHS Trust ; Oxford ; UK
  
• 关键词：Organisational culture ; Competing Values Framework (CVF) ; Post ; merger integration ; University Hospital ; Academic Health Centre (AHC) ; Academic ; Clinical Collaboration ; Strategic partnership ; Research and innovation ; Teaching ; Patient care
• 刊名：BMC Health Services Research
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
• 全文大小：770 KB
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• 刊物主题：Public Health; Health Administration; Health Informatics; Nursing Management/Nursing Research;
• 出版者：BioMed Central
• ISSN：1472-6963

文摘

Background Around the world, the last two decades have been characterised by an increase in the numbers of mergers between healthcare providers, including some of the most prestigious university hospitals and academic health centres. However, many mergers fail to bring the anticipated benefits, and successful post-merger integration in university hospitals and academic health centres is even harder to achieve. An increasing body of literature suggests that organisational culture affects the success of post-merger integration and academic-clinical collaboration. Methods This paper reports findings from a mixed-methods single-site study to examine 1) the perceptions of organisational culture in academic and clinical enterprises at one National Health Service (NHS) trust, and 2) the major cultural issues for its post-merger integration with another NHS trust and strategic partnership with a university. From the entire population of 72 clinician-scientists at one of the legacy NHS trusts, 38 (53%) completed a quantitative Competing Values Framework survey and 24 (33%) also provided qualitative responses. The survey was followed up by semi-structured interviews with six clinician-scientists and a group discussion including five senior managers. Results The cultures of two legacy NHS trusts differed and were primarily distinct from the culture of the academic enterprise. Major cultural issues were related to the relative size, influence, and history of the legacy NHS trusts, and the implications of these for respective identities, clinical services, and finances. Strategic partnership with a university served as an important ameliorating consideration in reaching trust merger. However, some aspects of university entrepreneurial culture are difficult to reconcile with the NHS service delivery model and may create tension. Conclusions There are challenges in preserving a more desirable culture at one of the legacy NHS trusts, enhancing cultures in both legacy NHS trusts during their post-merger integration, and in aligning academic and clinical cultures following strategic partnership with a university. The seeds of success may be found in current best practice, good will, and a near identical ideal of the future preferred culture. Strong, fair leadership will be required both nationally and locally for the success of mergers and post-merger integration in university hospitals and academic health centres.