Restructuring and Mergers

Review
In: Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 24.

Excerpt

As reflected in the Table (see above), most studies of restructuring and mergers have been conducted in acute care settings. Many of these studies have examined the effects of restructuring and mergers on cost, staff nurses, and patient outcomes. In the aggregate, restructuring and mergers did not achieve the desired reductions in cost. However the upheaval accompanying restructuring efforts and mergers can be related to lower job satisfaction among nurses and increased burnout. The effects of restructuring and mergers on patient care, however, are more difficult to understand because the evidence varies over time, by hospital or unit, and by unit type.

There is convergence in findings about sources of job dissatisfaction and burnout related to restructuring and mergers. Organizational and unit leaders would be wise to carefully assess work relations, work responsibilities, and the availability of resources, all of which may be sources of dissatisfaction and burnout. It would also behoove the leaders to consider the evidence that illustrates ways to minimize the undesirable effects of restructuring and mergers. These include empowerment, empathetic leadership, and staffing changes that increase the number of licensed nurses who are employed by the institution.

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