Published: 14 December 2018

Meaningful dialogue overcomes barriers in hospital mergers

Researchers: Martin Keane, Dr Marie Sutton, Louise Farragher, Dr Jean Long, HRB Evidence Centre

In summary

Ahead of the merger of three existing hospitals (Temple St, Crumlin and Tallaght) into a new children’s hospital on the campus of St James’s Hospital in Dublin 8, the Department of Health asked the HRB to review research on the barriers and facilitators to successful hospital mergers and to identify good practice as reported in the literature. The results show that good communication and dialogue between senior management
and hospital staff is a key to the successful implementation of hospital mergers.

The problem

Three existing hospitals will merge in the creation of the new children’s hospital in Ireland, and research was needed to identify the factors that hinder and facilitate the successful implementation of hospital mergers.

The project

HRB researchers looked at the international literature on hospital mergers and found a lack of reviews in the area. The researchers carried
out their own systematic review of available data across 49 published studies, particularly exploring issues in hospital mergers such as
culture, priorities and communication, and looking at what tends to be linked to success.

The outcomes
  • The research found that mergers were hindered when hospital staff were excluded from active participation and dialogue and when the staff felt their autonomy and professional identity was threatened.
  • Successful implementation was linked to clear communication and less distance between senior management and staff.
  • The study was presented to the Department of Health and published on the Department’s website following positive peer review.
  • The findings have been presented to stakeholders who will be involved in the upcoming merger to create a new children’s hospital.

Martin Keane, HRB Evidence Centre, says: “We found that the distance between senior management and hospital staff is a greater threat to a merger than any cultural differences between merging institutions. People were quite surprised and encouraged that good communication and dialogue can overcome cultural issues in hospital mergers.”