title: Facilitating organizational mergers: amalgamation of community care access centres.
abstract: BACKGROUND
  The development of 14 Local Health Integration Networks (LHINs) in Ontario necessitated the re-organization of Community Care Access Centres (CCACs). The achievement of LHIN objectives was contingent upon the organizations responsible for home and long-term care placement being aligned within the LHIN geographic boundaries. This re-alignment required 42 provincial organizations to re-structure, integrate and reduce to 14.
  
  
  METHODS
  This project was focused on the amalgamation of two CCACs in the Waterloo Wellington LHIN. Both were distinctly different due to their organizational evolution, the composition of the region and leadership approach. The different organizational cultures, if not managed properly, could result in a derailing of several current projects that were underway and were also key to the overall health system transformation agenda. A literature search provided a plethora of critiques of organizational change approaches and practical suggestions. Of particular relevance was a report to the Royal Commission on Health Care in 2002 that authenticates the dismal success in health care to meet change objectives. The project included a joint planning day for the leadership teams of the two organizations followed by an Organizational Readiness Assessment conducted by the Canadian Council on Health Services Accreditation (CCHSA).
  
  
  RESULTS
  Both activities brought the leadership and staff of Waterloo and Wellington together, started the integration process and solicited staff participation. A follow-up survey of the leadership teams revealed the effectiveness of the project in advancing integration between the two organizations and recognizing organizational cultural differences. The CCHSA Organizational Readiness Assessment process was viewed as an effective means for advancing the integration of the two organizations, particularly as it relates to allowing the staff groups to define for themselves the benefits of the merger.
  
  
  CONCLUSIONS
  The lack of hard evidence on the benefits of a merger could have been problematic in terms of resistance to change if the CCHSA process had not been used. The readiness assessment report provided 49 recommendations that served as baseline information needed for the design of a change strategy that is anchored in knowledge of variation in organizational culture, practice, communications, client service and leadership style.
authors.affiliation: Member Outreach Services, Ontario Medical Association, 525 University Avenue, Toronto, Ontario, Canada. kmercer5619@rogers.com
authors.forename: Kevin
authors.initials: K
authors.lastname: Mercer
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D004059:Diffusion of Innovation; D017598:Efficiency, Organizational; D006297:Health Services Accessibility; D006801:Humans; D009864:Ontario; D009935:Organizational Affiliation / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D009936:Organizational Innovation; D012040:Regional Health Planning