Lees Martin, Taylor Gina
Lambert Hospital Group, Sarnia, Ontario, Canada.
J Health Hum Serv Adm. 2004 Spring;26(4):470-84.
Even small mergers have big consequences. This case study demonstrates the complex nature of organizational change found even in small organizational subunits and provides important insight for managers and leaders who have completed or are considering such mergers. The study examined the amalgamation of two emergency departments. Quantitative and qualitative techniques were used to analyze the planning, implementation, and outcomes of this amalgamation on the nursing staff. This case study draws upon the literature pertaining to change survivor's syndrome, prescribed approaches to change, and the difficulties in changing cultures and making complex decisions. Change in hospitals has been shown to have negative consequences for nurses. The goal of this study was to examine in greater detail what aspects of change are associated with these effects. The findings suggest that the planning of the amalgamation was consistent with rational decision-making. The goals of changing to a single emergency unit and cost savings were achieved. However, the nurses experienced stress due to the pace of work and the physical layout of the newly renovated department. The findings also suggest that personal-level problems that the nurses experienced were consistent with the consequences of survivor's syndrome, the psychological contract, and communication issues. It was recommended that the organization undertake initiative to alleviate these stresses.
即使是小规模的合并也会产生重大影响。本案例研究展示了即使在小型组织子单位中也能发现的组织变革的复杂性，并为已经完成或正在考虑此类合并的管理人员和领导者提供了重要见解。该研究考察了两个急诊科的合并情况。运用定量和定性技术分析了此次合并对护理人员的规划、实施及结果。本案例研究借鉴了与变革幸存者综合征、规定的变革方法以及文化变革和做出复杂决策的困难相关的文献。医院变革已被证明会给护士带来负面影响。本研究的目的是更详细地考察变革的哪些方面与这些影响相关。研究结果表明，合并的规划符合理性决策。向单一急诊科转变以及节省成本的目标得以实现。然而，护士们因工作节奏和新装修科室的物理布局而感到压力。研究结果还表明，护士们经历的个人层面问题与幸存者综合征、心理契约及沟通问题的后果相符。建议该组织采取措施缓解这些压力。
