Communication is key during a merger
You must be open to workers' concerns
One of the most difficult aspects of merging companies is getting through the merger as a team -- and with a positive attitude.
"There's a tremendous amount of misinterpretation and miscommunication," says Cynthia Tyger, RN, MBA, CNAA, the director of home health for Pinnacle Health System in Lemoyne, PA.
Especially for directors and managers of home care companies, the pressure is tremendous. Their jobs are at the greatest risk, yet they have to remain strong to help their employees handle their fears and disillusionment. Though this is difficult and time consuming, proving your ability to manage your employees through a merger will put you in line for the high-level management positions that a merger usually creates.
Here are some tips for keeping your employees' fears assuaged:
* Meet with your hospital executives immediately.
If you aren't part of the management team that made the decision to merge, you should insist on meeting with your company's top executives immediately to get as much information about the merger plans as possible, says Judy Walden, RN, MHA, the president and chief executive officer of the Visiting Nurse Association in San Diego, CA. This will help you lead your staff better, and it will help calm your own fears too, she says.
* Develop new and faster methods of communication.
When SantaFe HomeCare in Gainesville, FL, merged with the Shands system this past winter, Laura Waltrip, RN, who was then SantaFe's chief operating officer and who is now the area executive director, helped set up a special telephone voice mail system to answer employees' questions about the merger as quickly as possible.
Employees left their questions in a voice mailbox created for merger-related questions. The password to the box was chosen so all employees would remember it: the password was HELP.
Waltrip or her assistant checked the special voice mailbox several times daily. At the height of the merger process, Waltrip's assistant checked the phone mailbox hourly, and if a reply was needed urgently, she paged Waltrip, who answered the queries with an e-mail or voice mail. This was faster than in-person communication, Waltrip says.
A newsletter is another way of disseminating information. The community relations department at Home Health VNA in Haverhill, MA, put out a merger newsletter called "Emerging News" once a month during the seven-month period between the announcement of the merger and the actual consolidation, says Karen S. Hanley, RN, MS, the vice president of admissions for Home Health VNA.
* Set up focus groups before the actual merger happens.
Holding small focus groups with employees before the merger occurred could have helped reduce the confusion and level of anxiety employees felt, Waltrip says. She didn't do this when her company merged, and she wishes she had thought to do so now.
"It would have been a good way to discuss and learn what's important about the current culture of your company that you don't want to lose in the merger," she says.
Force-fed information
* Hold mandatory inservices.
Typically, when a merger is announced, the CEO of the hospital will meet with all the company's employees, including the home care staff. But Hanley found that none of the home care staff responded when at the end of the CEO's talk he asked, "Does anyone have questions?"
Next, Home Health VNA held a series of informational sessions for employees, but very few people came.
Despite those two problems, Hanley says she and the rest of the management team knew the staff had lots of questions to ask. So they held mandatory inservices, during which managers and external consultants who specialize in change management spoke on subjects including:
-- how reimbursement is changing;
-- how managed care works;
-- how staff can be leaders;
-- what managed care organizations want from home care staff;
-- comparisons of how Medicare patients and managed care patients are cared for differently.
There was no punishment for not attending the inservices, but making them mandatory forced staff to go and learn about the upcoming merger.
"It worked. It was a great forum for feedback. People asked lots of questions and we got into discussions. You could see how they were interpreting the information we were giving them, and how what we said could be misinterpreted," Hanley says.
Discuss changes at all levels
* Make sure your subordinates communicate with their staff.
In addition to needing your own plan for how you will inform your staff of the changes your company is going through, you need to make sure your subordinates also have a plan for communicating these changes with their staff members, Hanley says.
When her company, Home Health VNA was created from a merger of two VNAs, Hanley says it took her a little while to realize that she needed to ask her subordinates about their plan for disseminating information.
"I didn't tell them how to get information out; I just asked them whether they had a plan for doing so, and that was enough," Hanley says.
* Be prepared to say everything more than once.
"During a merger, there are extremely high levels of anxiety, and people just get to the point where they can't absorb any more information, so you have to be willing to tell them again and again," Hanley says.
For example, a lot of the logistical information that was announced the same day as the merger itself was lost on employees who were too shocked to really listen to what was being said after the word "merger."
"You have to prepare people for change. Tell them what's going to change before you change it, tell them as the changes happen, and tell them after what you changed," Hanley advises.
* Tell what you know as soon as you know it.
Normally the hospital or health system executives who have agreed to the merger don't know exactly how the merger will happen, and a plan must be created to do so. This naturally can take months, giving ample time for fear and suspicion to take root among employees.
The best way to handle this time is to explain how the merger plan is shaping up as often as possible, even if you don't really have any new material to cover in them, Tyger says. Her company held regular personnel meetings as the plan for the merger unfolded. At the time, Tyger was the director of nursing, and she said she found those meetings to be helpful and reassuring. Later when she became the head of the company's home care operations, she continued holding the meetings.
It's a business decision
* Explain the reasons for the merger.
All levels of employees need to know why the merger is happening and how the merger will change the market positions of the companies involved.
"People need to know that this is a business decision, not a personal one," says James J. Turri, MS, MBA, the senior vice president for outreach services for the Susquehanna Health System in Williamsport, PA.
One forum in which to explain the reasons for your company's merger to your employees is to hold small meetings with all levels of staff. Walden did this just before going public with her decision to invite other VNAs in her region to become a merger partner with her company. She also followed up these meetings with letters she sent to all of her employees at home.
"I let them know that we simply can't reduce our costs anymore without benefiting from economies of scale, so we're looking to merge and widen our geographic coverage," Walden explains.
* Acknowledge and correct rumors quickly.
While the groundwork for the merger plan is being laid -- planning teams are put together, possible plans of action brainstormed -- there's barely any news to give employees. Even though you may hold regular meetings to explain this, employees will grow anxious when they don't hear new information.
"That's fertile grounds for rumors to spring up," Tyger says.
Address rumors as soon as they come up, Tyger recommends. Once she learned that she would take the new home care directorship, she asked at every meeting whether employees had heard any new rumors; if so, what they were and if the employees would allow her to correct the rumor.
"I encouraged them to ask me for confirmation whenever they heard a rumor," Tyger says.
Be honest
* Don't be afraid to say, "I don't know."
The sense that managers aren't being completely upfront with information can give rise to heightened fear and suspicion among employees. This will happen if you are asked a question about the merger that you don't know the answer to and you try to fudge it, Turri says.
"If you don't know the answer to employees' questions, say so. Don't fabricate an answer," he says.
* Explain any changes in plans immediately.
Be careful how you handle complications that come up as the merger progresses, Tyger says. For example, because of accounting rules, the new salary and benefits packages at Pinnacle Health System's home care company couldn't be activated as early as originally thought. This, of course, was cause for ample consternation among employees and had to be explained delicately.
"Lots of stuff comes up unexpectedly during a merger. You have to be real careful what you say, or you'll start a domino effect and then have to spend hours putting out fires," Tyger says.
* Look for danger signs.
From the time the merger is announced until the whole process is complete, you should look for these four indicators that your employees' fear level is on the rise:
-- an increase in staff resignations;
-- an increase in patient complaints or incidents;
-- a decrease in customer satisfaction;
-- staff obsession with minor details.
If you see that any of those are happening, address the problem immediately. For example, Waltrip learned that a few physicians who referred patients to the original home care company, SantaFe HomeCare, were concerned about whether the new company's values would meet their needs. Waltrip met with the physicians to reassure them that even though the company was going through a merger, the physicians' patients would be treated just as well as they always had been. *
* Karen S. Hanley, Vice President of Admissions, Home Health VNA, 1 Water St., Haverhill, MA 01830. Telephone (508) 373-1141.
* James J. Turri, Senior Vice President for Outreach Services, Susquehanna Health System, 1201 Grampian Blvd., Suite 2G, Williamsport, PA 17701. Telephone: (717) 323-0716.
* Cynthia Tyger, Director of Home Health, Pinnacle Health System, 325 N. Second St., Box 200, Lemoyne PA 17043. Telephone (717) 231-6363.
* Judy Walden, President and Chief Executive Officer, Visiting Nurse Association, 1450 Frazee Road, Suite 100, San Diego, CA 92108. Telephone: (619) 296-1800.
* Laura Waltrip, Area Executive Director, Shands HomeCare, 801 SW Second Ave., Sixth West Floor, Gainesville, FL 32601. Telephone: (904) 338-7179.
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