• Martin Lees and Gina Taylor.
• Lambert Hospital Group, Sarnia, Ontario, Canada.
• J Health Hum Serv Adm. 2004 Jan 1; 26 (4): 470-84.

AbstractEven small mergers have big consequences. This case study demonstrates the complex nature of organizational change found even in small organizational subunits and provides important insight for managers and leaders who have completed or are considering such mergers. The study examined the amalgamation of two emergency departments. Quantitative and qualitative techniques were used to analyze the planning, implementation, and outcomes of this amalgamation on the nursing staff. This case study draws upon the literature pertaining to change survivor's syndrome, prescribed approaches to change, and the difficulties in changing cultures and making complex decisions. Change in hospitals has been shown to have negative consequences for nurses. The goal of this study was to examine in greater detail what aspects of change are associated with these effects. The findings suggest that the planning of the amalgamation was consistent with rational decision-making. The goals of changing to a single emergency unit and cost savings were achieved. However, the nurses experienced stress due to the pace of work and the physical layout of the newly renovated department. The findings also suggest that personal-level problems that the nurses experienced were consistent with the consequences of survivor's syndrome, the psychological contract, and communication issues. It was recommended that the organization undertake initiative to alleviate these stresses.

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