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Merging Two Hospital Cultures Into Sanford Health

When Sanford Health in Sioux Falls, S.D., and MeritCare in Fargo, N.D., merged in 2009, they formed the largest rural, non-profit healthcare system in the nation. Here Mark Moir, PhD, who has been closely involved in shepherding the merger, discusses how it is working out. Mr. Moir, formerly a consultant, is vice president for organizational development at Sanford Health, the name of the new organization.

Bus links two organizations. To help bring together the two cultures, executives like Mr. Moir frequently travel between Sioux Falls and Fargo by a chartered bus, which runs daily. The trip takes three hours and 45 minutes one way. When he makes the commute, Mr. Moir wakes up at 4:30 a.m. at his home in Le Mars, Iowa, and drives by car to Sioux Falls to board the bus. On board he reads, chats with other executives and has access to the Internet.

A huge territory. The new organization covers more than 60,000 square miles in Iowa, Minnesota, Nebraska, Oklahoma, and the Dakotas. It has 30 hospitals, 111 clinic locations, more than 18,000 employees and more than 800 physicians.

No dominant organization. Although MeritCare eventually took Sanford's name, "this was not an acquisition," Mr. Moir says. "No one lost or gained." MeritCare became the Fargo region, Sanford became the Sioux Falls region, and Minnesota-based providers became the Bemidji, Minn., region.

No clash over who would be CEO. The former MeritCare CEO retired and Kelby Krabbenhoft, the CEO of the old Sanford organization, became the CEO of the new entity.

Gradual transition. Although Sanford Health and MeritCare merged in 2009, the former MeritCare organization was called Sanford Health-MeritCare until July 2010, when it took on the Sanford Health name. "We spent 2010 transitioning logically and methodically," Mr. Moir says. His work includes redesigning management practices and coaching employees and leaders.

Merger cost $700,000. "An enormous number of systems needed to be recalibrated," Mr. Moir says. Policies had to be aligned, such as choosing the same fiscal year and employee evaluation dates, and IT systems had to be merged. Former MeritCare entities are joining a new Epic electronic health record system that the old Sanford system was phasing in when the merger began.

Different cultures. While the old Sanford had a medical-center mission, MeritCare put more emphasis on physician practice. The two organizations' missions, however, were basically the same: "Dedicated to the work of health and healing," Mr. Moir says.

Looking for the "new we." Mr. Moir's team of eight people, which includes psychologists, a physician and a nurse, have been building what he calls "the new we" for the merged network. "Both Sanford and MeritCare have rich histories," he says, "but we wanted to create something that was new."

New mission and values statement. Mr. Moir and his team developed a new mission and values statement for the combined organization. "It's about courage and passion," he says. "We refined it down to a behavior level: 'Act with courage but treat each other with respect.' "

The new organization has five values: courage, passion, resolve, advancement and family. Mr. Moir says courage, for example, means encouraging employees to express themselves and to resolve difficult decisions with patients and their families. And resolve means having a disciplined approach and building systems that are reliable and sustainable.

Learn more about Sanford Health.


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