D258 Task 1 Merged Culture Leadership Plan Example

The Hallway and the Committee Room: Leading a Community Hospital's HIM Team and an Academic Health System's HIM Department Toward One Culture After an Acquisition

Student Name

Leavitt School of Health, Western Governors University

D258: Organizational Leadership in Healthcare, Task 1

Course Instructor

Month Day, Year

The Hallway and the Committee Room: Leading a Community Hospital's HIM Team and an Academic Health System's HIM Department Toward One Culture After an Acquisition

Two Cultures Coming Together

Lakeshore Community Hospital, a composite 140-bed hospital, was acquired this year by Summit University Health, a composite academic health system. Lakeshore's health information management (HIM) team of 16 people will join Summit's HIM department of 85 within nine months. As the newly appointed associate director for HIM integration, I am responsible for leading the combined team through the change.

The two groups do the same work in very different ways. At Lakeshore, decisions are made quickly and informally; a coder with a question walks down the hall to the manager, staff cover for one another without being asked, and many have worked together for more than a decade. At Summit, decisions go through written policies, a department policy committee and a formal chain of supervisors; work is divided into specialized teams, and performance is measured against published standards. In the terms of the Competing Values Framework, Lakeshore's HIM team shows a strong clan culture, built on loyalty and collaboration, while Summit's shows a hierarchy culture built on stability, rules and control.

Size and history matter as much as style. In a mixed-methods study of a merger between two public hospital trusts and a university partner, the major cultural issues were tied to the relative size, influence and history of the legacy organizations and what these meant for each group's identity (Ovseiko et al., 2015). Lakeshore's staff already describe the change as being "taken over," and some fear their jobs will disappear.

Leadership Approach

I would lead the integration using transformational leadership. Transformational leaders articulate a shared vision, inspire people to pursue it, give individual attention to each person's concerns and encourage staff to question old assumptions and propose better ways of working. This approach fits a merger because both groups must give up some of their old identity and accept a new one, which requires more than compliance with new rules. Reviewing twelve hospital studies of how leadership style relates to nurses' job satisfaction, Specchia et al. (2021) found that transformational leadership had the largest number of positive associations with satisfaction, while passive and laissez-faire styles were negatively associated in every study that measured them. A hands-off approach, letting the smaller team simply adopt Summit's procedures, would be the easiest path and the most likely to lose Lakeshore's experienced staff.

In practice, the vision I would communicate is that the combined department will keep Summit's consistency and Lakeshore's speed and teamwork, and that each group has something the other needs. Individual consideration means meeting one-on-one with every Lakeshore employee in the first month and with Summit team leads who will receive new staff. Intellectual stimulation means inviting both groups to challenge existing procedures rather than assuming that the larger organization's way is always right.

Culture-Building Functions

Three culture-building functions would turn the vision into daily practice.

Shared decision-making. A joint integration council with equal numbers of Lakeshore and Summit staff will review every HIM procedure that differs between the two organizations, starting with coding query practices and release of information workflows. For each, the council will recommend which version to keep, or a new one, based on results rather than on who wrote it. This tells Lakeshore staff that their knowledge matters and tells Summit staff that the policy process is still respected.

Socialization through partnerships. Each Lakeshore employee will be paired with a Summit colleague in the same role for the first three months. Partners will meet weekly, and Summit partners will spend at least two days working at Lakeshore, so that learning runs both ways. New Summit hires during the integration will also be introduced to Lakeshore's team, reinforcing that this is one department rather than a department and an annex.

Recognition that values both traditions. Summit's department recognizes staff mainly through annual performance awards; Lakeshore's team marked achievements informally and often. The combined department will keep the annual awards and add a monthly recognition segment in the all-staff meeting, where team leads name specific contributions, including ideas from Lakeshore that the council adopts.

Building One Team

Teams form through shared work more than through meetings. Within the first four months, I would launch a joint improvement project staffed by members of both groups on a problem both share, and publish its results to the whole department. Team leads will receive training in supervising people who are used to different decision styles, and job descriptions for combined roles will be written jointly by the integration council and human resources.

Conflicts Expected and How They Will Be Resolved

Conflict-handling modes can be mapped along two dimensions, as Thomas (1992) describes them: concern for one's own interests and concern for the other party's, producing competing, collaborating, compromising, avoiding and accommodating. Different conflicts in this merger call for different modes.

The first expected conflict is over procedures. Lakeshore coders send physician queries directly and resolve them within a day; Summit requires queries to go through clinical documentation specialists and a templated form. Both sides have good reasons, speed on one side and compliance on the other. This conflict calls for collaborating: the integration council will examine query turnaround and compliance data from both sites and design a process that keeps Summit's compliant templates while allowing Lakeshore's direct communication for simple questions.

The second is a conflict of identity and security. Lakeshore staff fear that the acquisition means job losses and that their way of working will be erased. Avoiding this conflict would let rumors spread. I would address it directly and early by stating in writing which commitments the organization has made about positions, by answering every question in open sessions and by accommodating on items that matter greatly to Lakeshore staff and little to Summit, such as keeping their local team huddle each morning. Where commitments cannot be made, saying so honestly is better than a vague reassurance that later proves false.

Conclusion

An acquisition joins two HIM teams on paper in a single day, but it takes deliberate leadership to make them one department. By leading transformationally, building shared decision-making, partnerships and recognition into daily work, and resolving conflicts according to their causes, the associate director can help Lakeshore's and Summit's staff keep what is strongest in each culture and build a department that neither could have been alone.

References

Ovseiko, P. V., Melham, K., Fowler, J., & Buchan, A. M. (2015). Organisational culture and post-merger integration in an academic health centre: A mixed-methods study. BMC Health Services Research, 15, Article 25. https://doi.org/10.1186/s12913-014-0673-3

Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership styles and nurses' job satisfaction: Results of a systematic review. International Journal of Environmental Research and Public Health, 18(4), 1552. https://doi.org/10.3390/ijerph18041552

Thomas, K. W. (1992). Conflict and conflict management: Reflections and update. Journal of Organizational Behavior, 13(3), 265-274. https://doi.org/10.1002/job.4030130307