In conclusion, clinical integration and interdepartmental mergers are necessary to improve cost, increase efficiency and improve the quality of service delivery. As a health care realignment process , it is important to build a communication plan involving all stakeholders throughout the merger process. Establishing clear lines of communication prevents resistance and employee distrust in the midst of transformational changes. Nurse leaders have the responsibility of keeping the employees engaged , committed and motivated to increase company productivity and sustainability. Finally, nursing leaders must design a utilization review staffing model with dynamic, competent, qualified staff members capable taking the department to
