Measuring the impact of transition, merger and opening of a new tertiary hospital on medical and nursing staff working within three Emergency Departments.

Mrs Rhian Rheinberger1, Dr  Julia Hocking2, Mrs Anne  Coverdale1, Mrs Anna Lichy1,3
1Queensland Health, Sunshine Coast Hospital and Health Service, Australia, 2Emergency Medicine Foundation, Brisbane, Australia, 3University of the Sunshine Coast, Sunshine Coast, Australia

Aim: To measure the impact merger, transition, and the opening of a new tertiary hospital has on medical and nursing staff working within three emergency departments measured over three time-points: 1) three months prior to orientation and education, 2) post orientation and education but prior to transition and 3) three months post transition.
Participants: All nurses and medical staff employed at the approved sites during the duration of the study.
Methods: Descriptive research using mixed method approaches. A Likert-type survey was developed utilising six major themes extrapolated from a literature search on change management.
Themes: 1) organisational vision, 2) clinical and interpersonal skills, 3) resources, 4) participation, 5) incentives and 6) organisational direction. Focus groups were run to illicit further discussion around staff experience.
Results: Time-point one represented a period of heightened anxiety, confusion, frustration and excitement for staff. Time-point two represented a period of enthusiasm, anxiety and job insecurity. A three-day orientation helped alleviate concerns and align the new team.  Time-point two represented polarised experiences. Members who reported feeling rewarded by the transition had prior job security, experience within the district, participated in transition activities, and had established supportive networks. Members who found the transition challenging reported feeling abandoned from management and leadership, felt communication and transparency was lacking, experienced job insecurity or reduced contract hours during the transition, and had limited supportive networks.
Discussion:  Staff reported transparent communication from leadership is crucial at all stages of change. Staff naturally found support within their team which was reported as the most effective coping strategy.


Anne Coverdale has a Masters of Advanced Nursing Practice; Graduate Certificate in Health Management and is currently employed as an after-hours clinical nurse consultant at Nambour General Hospital within the Sunshine Coast Health District. Anne has substantial experience working as a nurse unit manager and clinical nurse educator in the emergency department and has also worked as a member of the emergency helicopter retrieval team. Anne saw an opportunity to undertake research within our health district and enabled the collaboration of a small research team to document the impact major transition, merger, and opening of a new tertiary hospital would have on medical and nursing staff working within the emergency department.

Rhian Rheinberger has a Master in Public Health and Bachelor in Nursing. She currently works at the Sunshine Coast University Hospital Emergency Department and the University of Sunshine Coast. Rhian organised a small group of novice researchers, with the mentorship of Dr Julia Hocking, to undertake descriptive research within the Sunshine Coast district Emergency Departments. During her role as principle investigator she has facilitated the conceptualisation, design, implementation and analysis of the project.