Department of Primary Care and Public Health, Imperial College London, London, UK.
Saïd Business School, University of Oxford, Oxford, UK.
J Health Organ Manag. 2022 Jan 13;ahead-of-print(ahead-of-print). doi: 10.1108/JHOM-01-2021-0024.
Hospital mergers are common in the United Kingdom and internationally. However, mergers rarely achieve their intended benefits and are often damaging. This study builds on existing literature by presenting a case study evaluating a merger of two hospitals in Oxford, United Kingdom with three distinct characteristics: merger between two university hospitals, merger between a generalist and specialist hospital and merger between two hospitals of differing size. In doing so, the study draws practical lessons for other healthcare organisations.
DESIGN/METHODOLOGY/APPROACH: Mixed-methods single-case evaluation. Qualitative data from 19 individual interviews and three focus groups were analysed thematically, using constant comparison to synthesise and interpret findings. Qualitative data were triangulated with quantitative clinical and financial data. To maximise research value, the study was co-created with practitioners.
The merger was a relative success with mixed improvement in clinical performance and strong improvement in financial and organisational performance. The merged organisation received an improved inspection rating, became debt-free and achieved Foundation Trust status. The study draws six lessons relating to the contingencies that can make mergers a success: (1) Develop a strong clinical rationale, (2) Communicate the change strategy widely and early, (3) Increase engagement and collaboration at all levels, (4) Be transparent and realistic about the costs and benefits, (5) Be sensitive to the feelings of the other organisation and (6) Integrate different organizational cultures effectively.
ORIGINALITY/VALUE: This case study provides empirical evidence on the outcome of merger in a university hospital setting. Despite the relatively positive outcome, there is no strong evidence that the benefits could not have been achieved without merger. Given that mergers remain prevalent worldwide, the practical lessons might be useful for other healthcare organisations considering merger.
医院合并在英国和国际上很常见。然而，合并很少能实现预期的效益，往往还会造成损害。本研究通过对英国牛津的两家医院合并的案例研究，对现有文献进行了补充，该合并具有三个显著特征：两所大学医院之间的合并、综合医院与专科医院之间的合并以及规模不同的两家医院之间的合并。通过这样做，本研究为其他医疗机构提供了实际的经验教训。
设计/方法/方法：混合方法的单案例评估。对 19 次个人访谈和 3 次焦点小组的定性数据进行了主题分析，使用恒定性比较对研究结果进行了综合和解释。定性数据与临床和财务定量数据进行了三角分析。为了最大限度地提高研究价值，该研究与从业者共同创建。
该合并取得了相对的成功，临床绩效有所改善，财务和组织绩效有了显著的提高。合并后的组织获得了更好的检查评级，实现了无债务，并获得了基金会信托的地位。该研究得出了与能够使合并成功的意外情况相关的六个经验教训：（1）制定强有力的临床理由，（2）广泛且尽早传达变革策略，（3）提高各级别的参与度和合作度，（4）对成本和收益保持透明和现实，（5）对其他组织的感受保持敏感，（6）有效地整合不同的组织文化。
原创性/价值：本案例研究提供了在大学医院环境下合并结果的经验证据。尽管结果相对较为积极，但没有强有力的证据表明，如果没有合并，就不可能实现这些效益。鉴于合并在全球范围内仍然普遍存在，这些实际经验教训可能对其他考虑合并的医疗机构有用。
