Does it seem to you that you can't pick up a health care news journal without seeing an announcement of a new merger, proposed acquisition, or partnership? It does to me. On my last plane ride, I was catching up on the week's news and learned from a single edition of a weekly health care business magazine that:

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* A national 250-site surgery center company and one of the largest ambulance companies in the country have announced they are merging1(p13);

* Two hospital systems in California have partnered to build and operate a shared rehabilitation facility1(p6);

* Two New York hospitals are working together to share their clinical laboratories1(p31);

* Two of the larger health care insurance companies continue to pursue their merger despite opposition1(p2); and

* Two recent court cases (one in Pennsylvania and one in Illinois) resulted in a ruling against the Federal Trade Commission, which had tried to stop proposed mergers between hospital systems in those states.1(p12)

Featured in the same journal1^(p15) was a table comparing the size of the top 10 hospital systems, ranked by the number of acute care hospitals they owned in 2015. The 3 largest were reported to own 164, 112, and 103 hospitals, respectively. Of course, these mega systems consist of many more organizations than just hospitals-from clinics to provider outpatient practices sites, to long-term care facilities, to home health care agencies, to laboratories, and so on. They also have partnerships and partial ownerships that don't show up in a table. I know these organizations didn't expand to their size and scope through pure organic growth. They, too, are the result of mergers and acquisitions (M&As). In fact, they have probably pursued strategies that included multiple M&A transactions. All 3 may already have more hospitals in 2016 than those reported in 2015, because the combining of health care companies continues, in one form or another.

Most nurses are likely to experience (or have already experienced) working in organizations involved in M&A activities. That's why the Nursing Administration Quarterly editorial board chose this subject for the current journal. While it's important for all executives to understand the business ramifications for these activities, nurse executives have a special interest in understanding how they may affect clinical practice, clinical culture, standards of care, quality and safety, and care models. Nurse leaders also have central roles in maintaining a supportive environment for staff members, who will be anxious about changes to their work lives as a result of these business decisions. At the same time, we may be facing personal angst about possible (or probable) changes to our own positions, jobs, and/or employment caused by a merger or acquisition.

Guest editors Joyce Batchelor and Carol Bradley have put together a collection of articles to help inform nurse leaders about this trend. Authors who have lived through the days before, during, and after 2 or more institutions have combined to form a new organization have generously shared their learnings. Our hope is that their experiences will help their colleagues (you) to better navigate the world of M&As.

Thank you for choosing to lead,

-Kathleen D. Sanford, DBA, RN, FACHE, FAAN

Editor-in-Chief

Nursing Administration Quarterly

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