Organizational Growth through acquisition and partnership–the challenge of behavior change

Over the last decade our organization has had a phenomenonal rate of growth that has allowed to be highly succesful in the rapidly evolving healthcare economic landscape. Initial efforts were more localized and building alignment was a bit easier becuase of the increased visibility and opportunity for interaction. Now as we are growing more across the region the distances are greater and we are beginning to partner with or aquire organziations that had traditionally very different missions than our parent organziation. We have always valued patient care/service, innovation and education but as we partner with organizations that have never had education and innovation as major parts of their mission we face challenges at times with getting everyone to understand the importance of these missions and the need to change behaviors and practices to support this. On the flip side, as we face increasing cost challenges, we are faced with trying to change behaviors of those who do thngs for “academic interest” when the behaviors do not improve and cost more. The overall story I think is about the need to blend and change cultures and is something that typically takes time. However, I don’t know that we can just take the time to let things evolve–we have to try to find ways to speed the process.


Changing reimbursements and reducing physicians clinical revenue, can redefine the medical practice in an academic center?


Identify key elements of a successful discharge medication program

Participant comments on Organizational Growth through acquisition and partnership–the challenge of behavior change

  1. It would be critical to define or redefine the core values together with the vision and mission which will be embraced by new the employees joining via inorganic acquisitions. The core values should be deployed by the senior management and they have to find cultural ambassadors / leaders to disseminate the culture and vision at every level.

  2. With growth comes growing pains.
    Amalgamating organisational cultures, visions and missions is never going to be an easy scenario, nor do you ever hear such acquisitions going swimmingly well in the short term. I believe that strong leadership, a shared combined vision and change champions combined with patience, understanding and perseverance will get your team there in the long run.
    Good luck!

  3. We brought two equal-sized organizations together 6 years ago; with two very different cultures (physician led and non-physician led). During the merger we focused on building a new culture by introducing “lean” management/organization principles and four core pillars/priorities for the new organizaiton. By introducing something new, I think it allowed employees to let go of the old cultures and focus on the new priorities and goals of the newly created organization.

  4. In merges and acquisitions this is much common to face, the lead of change in cultural behaviours is always challenging, one hint might be shared here from a similar experience; find out one of the existing leaders in the new organization that you believe he might lead the change and get him trained on your organization culture and values very well, let him lead the change internally, it’s always difficult for employees to listen to new comers.

  5. While it is true that this is an increasingly common situation, that doesn’t make it easy! A tone of mutual respect and give and take is key. No one group can expect to get everything they want. Everyone will have to change. It is particularly important in a case like this for there to be a shared mission statement, but also for senior leadership to make it clear whether there is a dominant group “swallowing the other whole” or whether there is room for mutual leaning. In the examples you give, I can imagine that the less education focused group may be able to teach the academics about how to practice more efficiently, while the academics may be able to provide more educational programs (perhaps with CME) for the non-academics. Culture change is always hard but in a large organization success is usually only achieved when the lower performers are brought up and are made to feel like part of the key to the organization’s success.

  6. If you have had a long spree of acquisitions and are a large hospital system do you think it is possible to have a philosophy of co-existence? Rather than having a singular definition and view of ‘who we are’ can you have multiple identities. For instance identify which hospitals in the system are going to be academics/research focussed and which are only going to focus on delivery of care. Make that distinction clear within the organisation and also to the community.

    The hospital that you acquired should have been doing something right, which is why you considered a merger. Now having merged, it may not be the best idea to suddenly tell them that they were wrong all along and from now on they must do everything differently. As long as the fundamental philosophies are shared and the direction is agreed upon, I think individual cultural differences should be accepted, and even leveraged.

  7. Building your culture to other organizations that have very different thoughts and behaviours has always been a big challenge. M&A strategy should ideally look for companies with similar cultures and attitudes, since this makes the transition much soft and easier and less “traumatic”. Although this kind of buying strategy is not always possible, I think implementing your organizations’ culture into the new one is just a matter of time and patience – people and organizations are frequently very resistant to changes, but after a while (months or even years) they will find that this is inevitable and if people wish to stay where they are, they will have to change the posture and behaviour.

  8. It is always a challenge to blend different cultures together or merge organizations with different vision and mission. This will require deliberate attempt at “Behavioral and Cultural Change” in the entire new organization. For change to truly be effective, a leader must know how to effectively communicate the benefits, minimize the barriers and describe the processes. Learn from your peers as they share approaches that were successful and those that impeded the change process. I believe there are areas of opportunity to blend in the parent organization and area of developmental changes in the newly acquired entities, overall, there should be a new and formidable culture and not one dominating others. This will require a painfully slow process but achievable with consistency and focus on the common goal/vision.

  9. What a great opportunity! The two groups bring diverse perspectives which when combined can be infinitely better than either alone. The “town gown” “academic community” splits are increasingly being addressed well in diverse settings. Engaging leaders from both groups together so they understand they are now “one team” is key and allowing the leaders of each to bring their teams along with clear support for the larger vision and mission. Also…look for opportunities that each side can bring forward projects that are meaningful to them that can be spread across the entire new merged organization. Re academic work seen as “unimportant”….two sides to this! As a researcher, I am eager to show our community physicians research projects that have impact in a positive way on our patients. Frankly, “we researchers” can be reminded by our community practice physicians that if our research isn’t having a positive impact on patient care we might consider a different approach. There is some truth in the perspective that academic physicians can be a bit out of touch and some truth to the perspective that non academic physicians can be a bit focused on present rather than future clinical care….creating a culture where both sides respect and listen to each other and find the mutual common ground to build on is exciting. Continually finding areas where “we all agree” and building trust around those domains can establish relationships and positive outcomes to leverage. Finally…..nothing brings people together more than a common “enemy” Do they all understand the critical importance of the merger? Do they understand they need each other to survive in the current healthcare climate? Do they see the increased power they have with insurers/payors as a larger organization?

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