Health care mergers and acquisitions: implications of robbers cave realistic conflict theory and prisoner's dilemma game theory.

Many health care mergers and acquisitions have proven highly successful because of the geographic proximity of the institutions, coalignment strategies, complementary services, and improved financial performance. Other health care mergers and acquisitions, however, have been dismal failures. This article seeks to explain a primary cause of less successful mergers or acquisitions through the prism of a multiscale, iterative prisoner's dilemma that occurs between department managers. Aspects of "Coping Theory," "Resource (Conservation) Theory," and "Social Comparison Theory" are used to analyze the experience of employees charged with making mergers or acquisitions successful. Lastly, this article suggests possible culture clash remedies drawn from the realistic conflict experiment conducted by Muzafer Sherif near Robbers Cave State Park in Oklahoma.

An employer's guide to controlling health care costs.

Employers are facing difficult times with respect to controlling costs associated with health care benefits provided to employees. Current trends in employer health care costs are unsustainable. Moreover, public policy changes in the form of the Patient Protection and Affordable Care Act are tied up in legal review, and the results are uncertain. This article provides a brief background on health care benefits and costs, discusses consumer-driven and traditional models of health care plans, and reviews cost-control tactics that employers should consider. It concludes with a review of the current situation with recommendations to employers for moderating future health care costs.

Layoffs at hospitals: a challenge for health care managers.

Like other organizations that are directly impacted by the state of the economy, some hospitals and other health care providers are discovering that staff reductions are realities that heretofore have been rare during recessionary periods. Consequently, health care managers are increasingly required to notify affected workers of layoff and convey to them critical information in meetings that are often fraught with anxiety and anger. Nevertheless, there are steps that the organization's managers can take to ensure that layoffs are addressed in a professional manner that maintains the trust and respect of the workforce.

Straight talk for health care managers: back to the basics of leadership.

Managers in the health care field should continually reflect on their leadership practices and the performance of individuals in their respective units, with an eye toward continuing improvement. A critical part of the reflective process is a review of the basics of leadership. This article presents information concerning 18 critical leadership topics and offers suggestions for improving performance.

Employment-at-Will: guidelines for health care managers.

Employment-at-will is a doctrine that allows an employee or employer to terminate the employment relationship at any time for any reason. This doctrine has eroded over time with the enactment of federal legislation that gives workers job protection. Moreover, various states recognize 3 major exceptions to the doctrine. This article examines the historical development of employment-at-will, discusses the pros and cons of at-will employment, describes the exceptions to the doctrine, and discusses at-will employment issues in the health care industry.

The looming health care crisis. Fact or myth?

Health care literature succinctly describes the challenges faced by hospitals today: shortages of skilled workers, escalating costs, government regulations, shortfalls in revenue, and similar concerns. To assess the relative importance that hospitals attach to these challenges, as perceived by hospital HR managers, a nationwide survey of 400 randomly selected HR managers was conducted. These HR directors were asked to rank-order various hospital concerns, assess the success their employers have achieved in dealing with such problems, and predict the difficulty of recruiting and retaining qualified workers in various job categories throughout this decade. In contrast to hospital CEOs, who regard financial concerns as their top priority, hospital HR managers rank shortages of skilled workers first. These HR managers anticipate continued difficulty in recruiting and retaining RNs, pharmacists, anesthetists, and some therapists and technicians throughout this decade.

Sexual harassment in the health care industry: a follow-up inquiry.

A nationwide survey of hospital human resources managers reveals that allegations of sexual harassment in hospitals are increasing. Reported statistics for a 4.5-year period show that nurses continue to bring the largest number of charges. Most are "hostile environment" allegations, and most formal charges are levied against coworkers. When compared to data gathered in an earlier survey, these statistics show an alarming trend. A significant increase in allegations occurred in 1999 and 2000, corresponding to two US Supreme Court rulings that clarify an employer's responsibility to eliminate this form of sexual discrimination from the workplace.