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

BMC Health Services Research

Alastair M Buchan⁴  Jan Fowler²  Karen Melham¹  Pavel V Ovseiko³ 

[1]Research Services, University of Oxford, Oxford, UK

[2]NHS England, Thames Valley, UK

[3]Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK

[4]Oxford University Hospitals NHS Trust, Oxford, UK

关键词: Patient care;    Teaching;    Research and innovation;    Strategic partnership;    Academic-Clinical Collaboration;    Academic Health Centre (AHC);    University Hospital;    Post-merger integration;    Competing Values Framework (CVF);    Organisational culture;   

Others  :  1089798
DOI  :  10.1186/s12913-014-0673-3

 received in 2014-03-17, accepted in 2014-12-17,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Ovseiko et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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