Transformation toward teamwork: a methodical approach to change. Three disparate cultures come together.

In January 1995, following a 19-month planning process, Fanny Allen Hospital, Medical Center Hospital of Vermont, and the University Health Center formed Fletcher Allen Health Care, a single operating entity. The University of Vermont is linked by contract to the new organization. From the beginning, the organizations' leaders approached the planning process with the human dimension in mind. Although the process was led by top leaders of the four entities, they relied on input from physicians and multidisciplinary teams of professionals. To gain employees' acceptance of the transition by making them feel secure, in December 1993, the organizations announced that no one would involuntarily lose his or her job for the next year. And managers have gained acceptance of the transition planning process by gaining input from employees and making it clear that the plans are not cast in stone. Nevertheless, both leaders and employees face anxiety and discomfort with change. In addition to fears about job security, they fear loss of control, quality, and a feeling of mission fulfillment. Communication has been fundamental to easing the transition. Leaders have delivered the same message to everyone, using a newsletter, employee meetings, management meetings, and a telephone hotline. Leadership education, development, and selection are other critical issues in helping employees adjust to change.