Abstract
This theoretical essay aims to propose a framework that enables to maintain the gains in hospitals involved with merger and acquisition processes by including the nursing leaderships. It implies a new perspective on the Structure, Conduct, Performance (SCP) model. If companies intend to grow with an adequate quality and sustainability standard, they must reverse the SCP model to CSP, in which managerial conduct, through nursing leadership, is the driver of the entire process, reflecting in the market structure and, consequently, in the performance. As methodological procedures, classical and contemporary academic studies on efficiency losses in merger and acquisition processes and nursing management have been critically reviewed and applied to support the argument in order to propose a framework.
Highlights
Hospital organizations are singular in one point: on one hand, the management is highly pressured to control costs; on the other, it is forced to offer specialized and highly qualified services (ARONSSON et al, 2011)
In the North-American hospital sector, for example, there was a reduction of 18% in the number of hospitals and 31% in the number of hospital beds since 2006 (COSTELLO et al, 2011)
This study aims to propose a framework that enables to maintain the gains in hospitals involved with merger and acquisition processes by including the nursing leaderships
Summary
Hospital organizations are singular in one point: on one hand, the management is highly pressured to control costs; on the other, it is forced to offer specialized and highly qualified services (ARONSSON et al, 2011). In order to avoid this tradeoff, since the quality management in this sector is directly related to the service outcome, organizations have opted for merging and acquisition processes as a way to obtain scale gains This has occurred both in Brazil and Europe, USA, and Canada (PÁDUA FILHO, 2014; WEIL, 2010). Fagerström and Salmelas (2010) stressed the importance of permanent dialogue with their direct leadership to reduce conflicts and uncertainties in hospitals through merger processes It is, about improving the managerial capacity or conduct through the nursing leadership as a means to achieve real benefits for the hospitals, given the need for concentration, without triple losses to society (increasing prices, fewer options, and reducing efficiency).
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