Tracking the merger: the human experience.

Research in two recently merged teaching hospitals has studied the effects of merger on the organizational culture of the hospitals and individual staff. Organizational culture is both a tool for managers introducing change and also an observable indicator of change, and hospitals have particularly strong cultures. After reviewing different approaches to analysing culture, and adopting Hofstede's six-dimensional model, the researchers describe one hospital as an aggressive, entrepreneurial, results-oriented organization, with a loosely controlled, devolved management, high expectations of staff and limited participation in decision making. The other is described as a tightly controlled, centralized and paternalistic organization, concerned for its staff and open to dialogue, with a principled commitment to partnership. The management's vision for the new trust combines elements of both cultures. In studying the effects of the merger on staff, the research documents individuals' journey through the merger experience, using Stuart's 'map' of the processes of change. The principal experiences are categorized as sensing, worry work, positioning, shock, hoping and sharing, holding on, letting go, moving, and moving on or away. Individuals' perceptions of the changing hospital cultures show a slow convergence but with new 'fault lines' opening up in the organization.