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The integration and consolidation of health care organizations may have a positive impact on their organizational performance and, what is even more important, they may increase the effectiveness and improve the quality of health care services being provided by health care organizations for patients. In this respect, health care organizations need to focus on the management of integration and consolidation to maximize their positive impact on the organizational performance. At the same time, it is important to remember that the integration and consolidation may raise a number of challenges and problems health care organizations will have to overcome to succeed and to improve their organizational performance and the quality of health care services delivered to patients.
First of all, the integration and consolidation of health care organization occurs in different ways. One of the most widely-spread ways of the integration and consolidation of health care organizations is their merger, when two or more health care organizations merge and one organization is created instead of two or more organizations. This process is accompanied by consistent restructuring of all organizations involved in the merger, including the integration of the personnel, facilities of health care organizations, equipment and infrastructure as well as the unification of their information systems and all elements of the organizational structure, which should become homogeneous and work within the new organization smoothly.
Alternatively, the integration and consolidation of health care organizations occurs when a health care organization is liquidated and its personal and equipment is transferred to another health care organization. Such cases of integration and consolidation are rarer because such integration and consolidation implies the centralization of the provision of health care services and the elimination of some health care organizations, which may be located in remote areas or which local communities cannot maintain financially.
Among the two aforementioned types of integration and consolidation the merger seems to be the most effective and tolerant in relation to patients and local communities because the liquidation of a health care organization leads inevitably to the deterioration of the quality of health care services and the limitation of access of patients to health care services. As a rule, in case of liquidation of a health care organization, patient need to attend another health care organization located in a different area, distant from their community.

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The integration and consolidation based on the merger implies that the infrastructure and the organizational structure of all organizations involved in the process of integration and consolidation is basically preserved and patients did not suffer from the decrease in the quality of health care services or their lower accessibility. In stark contrast, such integration and consolidation leads normally to the improvement of the quality of health care services and the better organizational performance of health care organizations.
However, mergers are not always successful and sometimes they may lead to the failure of the integration and consolidation of health care organizations. To put it more precisely, sometimes the merger of health care organizations leads to their disintegration and the decay of health care organizations caused by poor management and ineffective restructuring. In such a situation, health care administrators should remember about failures of mergers and their causes and factors that led to the failures (Solovy, 1995). At this point, it is worth mentioning the fact that one of the major causes of the failure of the merger is the unpreparedness of the personnel to the merger. What is meant here is the fact that when the personnel, health care professionals and the rest of the staff, are not prepared for the merger, when they do not have the full information about the merger and when they have not been involved in the process of the merger and preparation to the merger, the personnel is likely to oppose to the merger that leads to its failure. Health care professionals are uncertain in their future and they cannot work effectively. They oppose to changes provoked by the merger that decreases the effectiveness of their work to the extent that it may lead to the failure of the merger.
In addition, health care administrators should remember that mergers can fail, when the change management is poorly conducted. This means that health care organizations fail to integrate closely and the resources and facilities as well as professionals available to the new health care organization are not used effectively and the health care organization fails to use their full potential. In such a situation, health care administrators should focus on the maintenance of the existing organizational structure and preserving health care professionals from transferring to other health care organizations.
Finally, it is important to lay emphasis on the fact that the integration and consolidation meet the six aims of the Institute of Medicine. In fact, the integration and consolidation aims at the improvement of the effectiveness of health care services. In addition, the integration and consolidation make health care services patient-centered, safe, equitable and timely. Thus, the integration and consolidation leads to the overall improvement of health care services.

References:
Solovy, A. (1995). Predicting the unpredictable. Chicago: Hospitals & Health Networks.