Organisational issues surrounding the merger of two acute psychiatric services in

the south-east of Ireland

ByClaire Hayes BSc; RPN

Supervisors:Dr. Michael Bergin

Professor John Wells

Acute psychiatric services in Ireland-background

Current study and research design

Findings

Conclusion and significance of this study

Presentation Outline

Reform

Mental health policy

A Vision for Change (2006)

Organisational issues emerging as a significant concern

Acute Mental Health Services

Minimal research on psychiatric services in Ireland

No ‘how to’ guides

Mergers in a recession

Literature Gap

To explore and analyse the ‘how’ and ‘why’ issues, which may arise during the merger of two acute psychiatric services in the south-east of Ireland

Aim of Study

To identify and analyse the organisational issues, which arise during the merger of two acute psychiatric services

To examine how the change process affects the viewpoints of individuals involved in merging into a single service

Objectives

Case Study Approach

Methodology

Acute Mental Semi-structured Acute Mental Health Service Interviews Health Service A B Data Collection

15 Key Stakeholders n=30 15 Key Stakeholders

Purposive Sample

Analysis Thematic Analysis Nvivo 9

(1) Communication with senior management (SM) and health professionals (HPs)

(2) Merger Reactions

(3) Conflict between HPs and SM

Findings

(1) Communication

45%

25%

10%

15%

5%

Word of Mouth Media LetterMeeting Management

20%

60%

10%

10%

Letter Meeting Word of MouthManagement

Senior management Health professionals

Denial

Anger

Bargaining

Reactions of sadness

Acceptance

(2)Merger Reactions“I think it’s a short-sighted decision,

which ultimately will have to be reversed”

“I was annoyed. The main reason, very simply would be that 82% of the staff that were involved in the merger were not consulted”

“I felt I had a duty to the people of [county X] to try and find an

alternative”

“People were very sad at the loss of the admission unit”

“I’m fully supportive of Vision for Change, so it

wasn’t a disappointment for me”

(3)Conflict between HPs & SM

Merger Motive

“Economics”Merger Motive

“Policy”

Challenges

“Getting people to accept the change”

“If management listen to what employees are saying and get their advice, but they won’t, but that’s what they should do”

“I know there’s managers in offices who have to make decisions and they have to make them but I really think that they’re not in tune with working on the ground”

Consultation

Health professionals Senior management

Consultation

“In the ideal world, you would like to leave four or five months for

consultation. We didn’t have that luxury”

“You are never going to get everyone to agree”

Morale

Senior management Health Professionals

MORALE

“Morale is very good, positive,

full of enthusiasm”

“The morale level among the staff is at an all

time low”

Unequal Vision

Policy vs Economics

Separate agendas

Good Communication

Conclusion

Economics-Conflict

-Cost-effectiveness

Educational Future acute mental health service mergers

Significance of this study

To MergeAcute Mental Health Services in Ireland

Alaranta M. and Viljanen M. (2004) Integrating the IS Personnel After a Merger-Managing Challenges and Opportunities. ECIS 2004 Proceedings. Paper 23.

Boone L. E. & Kurtz D. L. (2009) Contemporary Business, 13th edn. John Wiley and Sons, New York.

Department of Health & Children (2006) ‘A Vision for Change’ Report of the Expert Group on Mental Health Policy. Stationary Office, Dublin.

Department of Health (1984) Planning for the Future. Stationary Office, Dublin.

Landy F. J. & Conte J. M. (2009) Work in the 21st Century: An Introduction to Industrial and Organizational Psychology, 3rd edn. John Wiley and Sons, New York.

Rukholm E., Lemonde M., Bailey P., Kaminski V., McLellan B., McGirr M., Palkovits J., Pong R. & St Onge R. (2003) Hospital System Assessment & Redesign for a New Millennium. Canadian Health Services Research Foundation, Canada.

References