Abstract
Today's dynamic health care environment is exceedingly complex, and health care facilities across the United States are struggling to respond to changes in technology, health care reimbursement, the Affordable Care Act, and the much-anticipated nursing shortage. Mergers, acquisitions, and integrations are the current health care reality. These are proposed to increase efficiency, efficacy, quality, satisfaction, and safety while effectively reducing cost to the consumer and stabilizing the economy of the health care system. Many of these projects fail to achieve objectives, even years after the formal change in status. Clinical education departments in merged organizations are often operated in the single-facility mindset, or contain an element of the shared services model. They are not truly integrated. Development of skills in complex analysis of current state, identification of desired scope of service and expectations of performance, and articulation of the benefits of the desired future state are all essential to nursing executive practice. This article describes an experience integrating 3 legacy education departments across 21 facilities into a centralized education system. The complexity of integration activities is illustrated and outcome measures of success are discussed. Barriers, facilitators, and risks of the project are identified and evaluated.