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The merger communications playbook

Well before the ink was dry on the memorandum of understanding for the proposed merger to create the Mount Sinai Health System, it was clear how great our challenge would be.

The pitfalls of merger communications stared us in the face, since our hospital network, Mount Sinai, had failed under a prior administration to successfully implement a merger with a rival Manhattan hospital, NYU Medical Center, in large part because the cultures of the two institutions never meshed.

Culture clash, management consultants report, is the leading reason the majority of mergers fail across industries. And communications errors – insufficient, ineffective, imprecise, inelegant, even inaccurate internal and external messages – frequently bear much of the blame for failing to bridge the culture gap. In other words, effective communications are essential to ensuring the success of a merger.

So when Mount Sinai leadership approached Continuum Health Partners and struck a deal in 2013, we were determined to get it right, to create and execute an exemplary communications plan to integrate Continuum with Mount Sinai Medical Center. There would be none of the false tropes of merger-speak: no empty promises, no idle happy talk, no public champagne bottle popping, no "merger of equals" proclamation, no dodging the difficult issues. Our communications would be frequent and frank, transparent and true.

Today the Mount Sinai Health System includes seven hospitals, a medical school, dozens of ambulatory care practices and more than 200 facilities where physicians treat patients- the largest such network in the New York City area and among the biggest in the country. While no merger is seamless, the combination has succeeded in creating a strong, integrated healthcare network. In part, that's because of the approach our team took in communicating the merger to everyone on both sides of the deal, as well as all parties impacted by the combination. Following are some key elements from our playbook that have contributed to the merger's success.

1) Inclusive Communications: Our communications were designed to maximize "buy in" by keeping employees informed and emphasizing the importance of both sides to a successful outcome.

A day before publicly announcing the memorandum of understanding for the proposed merger, we sent e-mails to all Mount Sinai faculty and staff, and the Continuum team did the same, so that all internal parties would receive notice first from leadership, rather than from the news media. We would keep them in the loop throughout the process.

2) A Clear Rationale: Immediately, we impressed upon leadership the urgency of putting to paper a mission statement, reasons for the merger, as well as talking points directed at every interested group- trustees, clinical chairs, faculty, staff, students, regulators, elected officials, community leaders and the media. The messaging would explicitly highlight the merger's genuine true benefits.

Externally, the focus was on the very real intention to improve and expand services to local communities. "Our goal in combining to form an integrated health care system and academic medical center is to provide exceptional medical care to New Yorkers," said Mount Sinai President and CEO Kenneth L. Davis in the press release announcing approval of the memorandum of understanding for the proposed merger.

Internally, there was an additional, far more urgent rationale that framed the entire transaction and clarified its importance: the rapidly changing healthcare business landscape that would be imposing harsher reimbursement standards upon providers. Dr. Davis made clear that large health systems would stand the best chance of surviving and thriving under new payment plans that increasingly would demand hospitals assume financial risk for the cost of treatment rather than the fee-for-service approach that had covered virtually any tests and treatments hospitals provided. Our CEO was especially frank in discussing the new healthcare landscape at a Mount Sinai town hall meeting:

"When you superimpose all the changes in healthcare, if we don't change, we're going to be very, very vulnerable, and to maintain ourselves as a great national academic medical center, we have to make changes. So, what are the successful centers? The successful centers are those that are the largest integrated healthcare systems."

Under the new payment scheme, proactive primary care would be critical in reducing expensive hospital admissions. Continuum had a very large network of primary care providers, which was a singular attraction for Mount Sinai.

3) Welcoming Communications: To further embrace Continuum, Mount Sinai opened the doors of its medical school to the physicians and researchers of Continuum, which did not have its own medical school. They would become part of the academic faculty at the Ichan School of Medicine at Mount Sinai. This made the Continuum medical staff feel wanted as they prepared to come under the Mount Sinai umbrella. Our students, meanwhile, would benefit from having greater opportunities for rotations at the Continuum hospitals.

Mount Sinai CEO Davis and Dennis Charney, Dean of the Ichan School, met with dozens of clinical leaders at Continuum, and were consistently welcoming and complimentary of them. This was yet another indication that the merger would be a full integration, and cultural compatibility would be a top priority, something that never happened during the attempt to join with NYU Medical Center in the late 1990s.

4) Direct Communications: Emphasizing the need for growth of the healthcare system helped assure medical staff their jobs were secure, and early on, Dr. Davis pledged there would be no change in employee benefits. At the same time, we explicitly stated there would be reductions in administrative staff and expenses. The cuts were held to a minimum, and the information was conveyed as early as possible. Fortunately, Mount Sinai's growth agenda resulted in a net gain in employment.

5) Constant Communications: Along with our messaging, we established a strict timeline for the CEO to personally contact all constituencies, including elected officials and regulators. Throughout the approval process, we dedicated ourselves to delivering frequent, clear and consistent communications. We sent e-mails to all employees updating them on the merger negotiations; Mount Sinai's CEO, the Dean of the Icahn School of Medicine, and the President of The Mount Sinai Hospital jointly led three town hall meetings before the merger was finalized where anyone could pose questions. The sessions were videotaped and promptly posted on the Mount Sinai website, where they remain available today. Continuum also held town hall meetings to keep its employees well informed.

Mount Sinai's online team communicated progression of the transaction on our social media sites, and built numerous pages for our website that answer frequently asked questions, provide details on the merging of information technology, human resources, facilities, development, and explain what the integration means to physicians, nurses and medical school students.

Since the closing of the merger in September, 2013, the communications effort has continued with updates on the website, e-mails to all staff, as well as a rebranding of the five acquired hospitals to reflect their complete integration into the Health System.

All these steps have been critical to creating a unified culture where former Continuum employees feel embraced and supported by Mount Sinai. Now, two years after the closing of the merger, the Mount Sinai Health System is recognized as one of nation's preeminent healthcare networks. Effective communications was essential to achieving this goal.

Dorie Klissas is the Vice President of Marketing and Communications at Mount Sinai Health System in New York City. Over the past five years, Dorie has led traditional marketing, internal communications and media relations for the Health System including seven hospital campuses and one medical school. Previously in 2011, Dorie served as Vice President of Media and Public Relations at Montefiore Medical Center, and from 2008 – 2010, was the Media Director at NYU Langone Medical Center. An Emmy award winning network television producer, Dorie was the chief medical producer of the "CBS Evening News with Katie Couric" from 2006 – 2008. From 1994 to 2006, Dorie was a producer of NBC's "Today" show, where she covered breaking news and wrote numerous award-winning medical series. Dorie also spent some time in front of the camera as a reporter for KARK-TV, NBC's affiliate in Little Rock, Arkansas. She has also anchored and produced "Let's Talk," a bi-weekly interview show on the Manhattan Neighborhood Network that focused on news, sports, business and the arts.

Dorie earned a B.A. in European History from Harvard University, where she was on the varsity tennis team, and later studied at the Graduate School of International Affairs in Geneva as a Rotary Foundation Scholar. As a junior tennis player, she was ranked #101 in the United States Tennis Association and #9 in the Eastern Tennis Association. She began her television career as an intern for Bud Collins at the US Open Tennis Championships in New York.

Leonard C. Achan, RN, MA, ANP is currently Chief Innovations Officer at the Hospital for Special Surgery in New York. Until recently, he was Chief of Access Services and Chief Marketing and Communications Officer (CCO) for the Mount Sinai Health System and Senior Associate Dean for Global Communications, Branding and Reputation for the Icahn School of Medicine. As CCO, he directed Marketing and Communications, branding, reputation management and Digital and Social Media services for all seven Mount Sinai hospital campuses and the Icahn School of Medicine. In Access Services, he led Executive and International Services, the Inter-hospital Transfer Center, Physician Access Services, and EMS- Ambulance and Patient Transport Services throughout the Health System. Mr. Achan began his career at Mount Sinai as a student-nurse intern after receiving his BSN from Adelphi University and his MA and adult acute care nurse practitioner degrees from New York University. In addition, Mr. Achan is a Fellow and Alumni of the Wharton School of Business, where he has taught entrepreneurial research, and lectures internationally as an adjunct faculty member of the City University of Hong Kong and the University of Macau.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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