Summarize in bullet points and brief explain each 3 references each page(scholar peer reviewed, at least one from the book ” Introduction to Health Care Management” by Sharon B. Buchbinder Nancy H. Shanks (2nd edition)

Write your interpretation of the results as you would in an APA-formatted journal.
December 8, 2020
Identify any specific Information Systems perspective adopted for the assignment
December 8, 2020

Summarize in bullet points and brief explain each 3 references each page(scholar peer reviewed, at least one from the book ” Introduction to Health Care Management” by Sharon B. Buchbinder Nancy H. Shanks (2nd edition)

Paper instructions:
(First page)
Return to “The Merger of Two Competing Hospitals: A Case Study” on pages 406–411 in Introduction to Health Care Management(in upload additional materials). In this case study, the transition team is brought together for a face-to-face retreat to decide how to resolve following issue:
1.Public concerns related to reduced competition following the merger

(Second Page)continue the case study “The Merger of Two Competing Hospitals”
Analysis of potential concerns and strategies for fostering productive communication and effective conflict management among the following:
2.The transition team members’ interactions with direct reports, colleagues, and others with whom they work on a daily basis

Summarize in bullet points and brief explain each
3 references each page(scholar peer reviewed, at least one from the book ” Introduction to Health Care Management” by Sharon B. Buchbinder Nancy H. Shanks (2nd edition)


tl“3C£_?CInl-;;I1lI}’. The following spring. a letter of intent to consolidate was sent from BRVC

‘W ‘“omh$ laftr. an agreement was solidified with the following requirements;

5. “Xhe consolidated hospital would have a new name; and

transitional team

deal with . including the pres ious CEO of PRMC, ould be assembled to
management changes and employee benefit packages.
b Ofh” ‘:°‘l“”‘3mCnts included a new mission statement, a policy that no workers would
6 laid off as a result of the i

merger, and a newly elected 1)-member hospital board
prised of 10 BMRC board members and 5 PMRC members Publi ‘ ‘ csmi
bv board membe ‘ ‘ C meetmgs “”36 Cld

‘rs and h
process. During the mectt_l>‘:p,i;t:itlh:iLdf:i‘ilil:i]istrator; to answer qfiiestions and explain the merger
an ‘ IC Voice concerns t at consolidat’ v 1 i
competition in the area lead’ ‘ ‘ ion “ on d demo”
mg to an increase in healthcare co d
and qualirv lii prelimim _ « sts an a decrease in sen.-icgs
1 . ‘ nr l
l°b Placcnlemv Compensation cbCe::1CcFf[t1ngs[the stafice”P“~‘559d Concerns over senioritv.
i ‘ pac ‘ages.
Leadership stvle at BMRC
could be characterized as 1rtic’

governing. As CEO ofBRMC, Pat Hermarpg . . . I _P. ipatiie, autonomous. and self.
that had been deflated bv the mi . ‘. initia Job was to rebuild the executing team
director of ‘ – ‘ I I-emu“ of the outgoln” CEO th

nursing services. and the depart“,-C of h ‘ . ° _ ‘ C 5e“°”5 ‘”0955 Oi (ht

PRMC “Pcrated as a siihsidiarv of VIHC t L “C9 PrC$lClL’nt of human resources

strategic mamgcmcm decisions .L i I i whose corporate office made all policy and

L. – 0VC]‘- eve mana ’ . s
dccisioti-making processes at MHQ Mam 6 gets were not lllghly imolved in the
centralized. Consequently flu m – 8 merit, therefore, was high“ Structured d

4 ‘ ‘ anfl Vcmcn g , an
for the d’1V-to- l« » . . – E I team at PRMC
4.‘ °P£rdtioiis of the hoSPlt:ll “llfd on the corporate ofhce
To embrace the new entity [h
bortsmltli Regional Media] 6 ( mmm‘‘”’l}’ decided to name 11
more tlrln l 400 I Q‘ ““CI’.At the time ofthe me h t 6 Consolidated hospital
cml‘ 0’ees. The s ‘ rger I ere was
positions had to compete for ‘h _ Itclblrllt both PRMC and BRl»[C ‘ d -{combined stall of
er s . in
condumn Ofstmmlini ’ – ‘rlo s. Approximately 90 Cl 1 uplicitt niamgemmt
H – 11;, positions. 1.200 e I i “P 0)’ees decided to retire. B’ the
criiiaii conducted 30 to 40 me . WP Oyees were pan of th
ers to answer their qucsm etings mt}, the SMT and c new organization.
in ‘ . , s
their feeliiigs l:n]pI()).{(‘ 3 and concerns. T he cmp] ma “°°ll}’ with the’.-
x.‘ ‘V. _ . v
L-mp[m.c‘_, relations perm” rnrlc [_l{ien access (0 fllc EAI) . es were encouraged to express
O . r I
ic P cope with their Fe P Ogram, social wo,k,_.rS_ and one
Culture Adaptation ms and “PPT€hensions
Cultures in
hols. and {on I Oiis are manifested
3 Procedures. AS a ‘i in lallguagc h
BIC entity, BRMC‘ ‘P )$lCal settings. values. sym-
lacl developed an ;llltonon1oU5-


T h sician’s time for credentialing would puf hi?”
time of consolidation. For examp c. I a.P’Y ‘ I. _ Md ,0 move to the shortest time in
her out of compliance. then the (.‘l:(.'(lcI‘lUflllng “mch’::)S ital had different peer review/qual-
order to maintain his/her current license. SIFICC. 65.15 T :1 sraffvoted to modify and adopt
it)’ Sm“dMdS’ the newly clcacd medical cxccum/L the time of consolidation, 160 Pb},
PRM(,”s more stringent, well-documented standar d) lewd 3 Smooth transition with
sicians at PRMC and I80 medical staffat BRMC 8 ComP
°”lY “V” Pllysicians choosing“) icavu . d – .nt An analysis of the combined

Another stalling issue was with the. nursilpg “Pa;-rrIi{cNs. to LPNS,was disproportionate
t1}{I;i)l’iI‘i11i:r:iii§)Sv:lavsl:):pbs:eri::iiiit was needed for the planned higly-tech

v. scular. 0 en Cart»
cart cauterr/a IO
excellence required a higher level of specialty nursing than Ywasneeded I1t:uS(l),‘-si’L.::‘ “”5
ing staff ratio needed to be changed to a 60:40 RN to. LPi ratio as MP1 P ~ ff ‘ Tdcd
ln addition. the staff analysis revealed that the skill levels of other existing stat nc

to be developed rapidly in order to perform in a more (CCl1I‘llCflll)”;1Ci’;1I‘I€Cd environmfifldf
that included picture archiving computerization systems. electronic medical records. an
new patient systems technology.


Each hospital oflered its employees benefits that included sick leave. paid time oll. health
insurance. life insurance. and retirement plans. Paid time oliiand sick leave were accrued at
dillcrent rates at each hospital. BRMC was sell‘-insured. while l’l{MC oliered its eniplo_”
cos a fully insured healthcate plan. ln addition. liealtlicare coverage. deductibles. premi-
ums. and out-oli-pocket costs varied between the hospitals. PRMC einployees feared ilul
they would lose benefits ifthey moved to the BRMC retirement svstein. ln the end. ‘)0
BRMC employees opted to leave the organization For fear oflosiiig their benefits. :iiotliCf
group opted to stay in order to obtain a licltcr benelit package.

Two months later. the newly‘ formed board and e.ecutives. including Herinan and
M iller. met at a planning retreat in _].icl-tson, Vyoining. to decide how to best resolve lead-
ership. culture adaptation. human resource manageincntt staliing. and lwenelits is.~‘1It‘-“-

1. What specific steps should the board take to Cl'(“ltC 1n ‘ ‘ _ . (in.

newly’ created organization? ‘ ‘ °“C”“”‘~‘ WM“ U‘ “‘-“‘-‘E-‘

2. Given the diversity oliculinres enihcddeil in th – ~ – – l ullil

(hc m;.n;.gc,m.,,[ [mm d” m fadlimc E‘ wurk‘ t rm rged urg.iinr.iiimi. ~lI.ll‘s u:
‘”3 mlfilft‘ in the new oQ‘,.IlI{.lll‘”~

indepentlcllt. Sclli-difcctcd Culture. I’RMC’s culture was much less independent and relied
j…_“-ily on the corporate ollice for its decision making. policy development. and operating
pl-u.‘t‘o.llll‘t’.. These factors greatly influenced the culture ofcach organization and the final
inipact on the consolidation of the new entity.

l‘R.lC and BRMC referred to each other in competitive language. There were many
relereiices to “them‘‘ versus “us” within the organizations. The language was indicative of
the entrenched processes, cultures. loyalty, and systems that had to be addressed in the
Both organizations had symbols that represented their cultures. Each organimtion had

a logo that symbolized who they were and what they represented. PRMC had a vision and
niission statement developed and defined by the corporate oflice, while BRMC. on the
other hand. did not have a clearly defined mission and vision statement. Although BRMC’s
board and Pat Herman had determined their vision and mission statements for the future,
these statements were not clearly defined and were not communicated to the staff.

Human Resource Management

A year alter the merger. a new vice president of human resources. Dale Miller, was
recruited from a Catholic healthcare system in Kentucky to handle the newly merged
hospital. ililler had e.’tensive experience in mergers and acquisitions. Soon, he realized
that the merger included more than the consolidation of duplicated services. The merger
also brought together two dillerent hospital boards. two separate groups of physicians and
stall. and two dillerent benefit packages.


There were several major stalling concerns For the consolidated hospital. Six months prior
to consolidation. PRMC and BRMC had to develop a joint medical structure that included
lfidersliip. credentialing. bylaws. rules and regulations. and peer review. Both hospitals had
three medical stallileadersliip positions: Cl1lCliOllSI£1l’l”. vice-chief. and se-cretar_’.‘lior a total of
six ph}.SicimS_ A process was developed to consolidate these siit positions to lour. Four of
the existing phvsicians’ names were recommended to the medical stall: and subsequently.
‘ht’ stall‘ voted to retain all Four to lead the new. consolidated medical stall. BRMC’s Dr.
(icnc [{(,§,(.m bL.C_1,m. thc new chiefiolistallioll Portsmith Regional Medical Center.

Tl1Cl1C'[ step required evaluating the dillerent bylaws. rules. and regulations Tor each med-
ical st:if}’;u pRMC and BRMQ Through a ballot. the two medical stalls decided to adopt
l’i_l:i’. fulcg‘ and n.guhm,n; that reflected their joint decision-making ellorts. Credentialing
ll“ No iiiedieal stalls required interventions b)’ “ l°E3“l mam‘ Swfce fiver-V ph-Vslcmn must

lit “°dL’Iitialetl every two vears. both hospitals had to de’.cloP‘ 3 Umt‘l’.m’ Ihi” “’0“l*.l
ll“ lniiit Coiniiiissioifs stlandards that would l-cc<-‘P llhllslcmns Credcnmls Clmcm with the

TNE MFRCEP or Two COMM 1 mt; llusI‘IYAt 2. 407
Last year. tl1€ h°5l’l‘“l’5 “P°’3Ilflg htidget was 53-1 million. llms-ever. in the ..Im(‘ year.
the hospital experienced $1 million loss. and a prntectetl SStNI,tNm Ion .u altlls ipatetl
for the following year. After three years of red ink. l’RM(I tlecitlt-tl to Iittiiitlaic.
Hospital B: Banner Regiorzal Medical Center (BRA! C)
and Turner Germtrzc Center
Built in 1951, Banner Regional Medical Center (BRMC). :i eotttity-ownetl ltmpital. was
located on the west side oftown. The hospital structure included I’M iltp.ItieIII lN'(l and .I
ocrl;lIl’lC healthcare center that consisted of l()()~ I ()6 hcds. I5 lt;lnsititm.Il «ate lmls. and 7
fehabilitation beds. A medical office huilding with a parking structme was ltN‘.Il(‘tl .uli~.u’ent
to the hospital. The catnpus consisted of Sol .366 square feet oliluiiltliny, spatt‘. lItItlt'(lnl1
6acres. The hospital’s operating budget for last year yvas $7‘) million. l’oRM( I had .I reserve
fund ofS20 million earmarked for major renovations to the existing facility’s etnt-tgeticy
room and intensive care unit. BRMCS services included the Herman (lancer (fenter,
Family Centered Care (Ob/Gyn), a newborn intensive care unit. a women’s center‘. life
Flight (mobile intensive care), a regional pediatric unit, a geriatric center. and a sports/
industrial medicine clinic. The hospital had a staff of 914 employees.

While the majority of the services were housed at BRMC. the home health administra-
tive offices and the physical therapy departments were housed at different locations in the
same town. For strategic planning purposes, management knew that the liospital’.s viability
depended on the necessary action to expand and renovate the facility to meet the needs of
its current market.

The stage was set for the consolidation ofthe two competing hospitals: PRMC. crippled
with three years of losses, and BRMC. struggling with aging facilities. The process would
take the next three years to complete the merger and create a new facility. BRlvl(I’s board
ofdirectors offered the facility to the county, so as not to let an outside organization corn-
pete for its resources and patients. The county would pay $25 million. to he paid in incre-
ments ofSl5 million at the time of purchase and SI() million over the next two to three
years. interest free. The CEOs of PRMC and BRMC, Pat Herman, MHA. F/Cl‘lli. and
Scottlohns, MBA, had applied for the single hospital management slot. A consulting lirm
fmm Seattle was hired to review the resumes, experiences, and job performances of both
1611. In the end, the commissioners voted to hire Herman, who had more than 20 years as
3“ administrator for a Catholic institution and had been the chief communication officer

for a military academy.


figilfsfiilll. the chairs of each hospitafs board met to discuss options for cutting healthcare costs.
8 the shortage of healthclre personnel, and improving the delivery of health care in

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