When Hannah Cassatly, ’16, arrived for the first day of her internship with a palliative care practice, the tension in the air was unmistakable. It was May 2014, and the practice was one of two very different healthcare organizations on the verge of a merger. Over course of that week, Cassatly, a leadership studies major and healthcare studies minor, witnessed administrators, clinicians, and nurses bracing for the merge. And then the “go live” day came.

“Chaotic,” remembered Cassatly. “That second week was just phone calls and acting on your feet.”

During her internship, Cassatly wrote journal entries about the rollout of the transition and the settling out of the initial tumult, but it was taking Group Dynamics with Professor Don Forsyth the following spring that spurred Cassatly think more critically about her experience. Cassatly’s research into the topic resulted in a case study, “A Common Healthcare Problem: The Integration of Two Healthcare Systems,” that builds upon leadership studies literature to make recommendations for improved communication during healthcare transitions.

“It’s important for practitioners to know that they have a clinical member or representative sitting on the board that makes decisions. They don’t feel fought for otherwise,” said Cassatly.

Cassatly’s article, which will be published in the November/December issue of the Journal of Medical Practice Management, considers the relationship between healthcare administrators and clinical practitioners and the need for leadership development in the healthcare industry. During her internship, Cassatly observed a lack of communication between administrators and clinicians that resulted in what she calls the “blame game.”

“They don’t even physically interact on a daily basis, unless there’s a problem,” said Cassatly of the existing relationship between administrators and physicians.

Based on her research, Cassatly advocates for creating venues for communication to improve efficacy during transition periods, citing examples of administrators who conduct rounds and who schedule weekly team meetings. In addition to creating a forum in which administrators and clinicians can become acquainted, these interactions create opportunities for clinicians to proactively ask questions and voice concerns rather than reacting to announcements.

While writing the article, Cassatly worked at a teaching hospital through the Jepson internship program and had a chance to see how proactive communication can facilitate changes. One of the projects Cassatly worked on was a change to emergency room processes.

“It had a similar feeling to the merger in that there was a 'go live' date,” said Cassatly.

This time Cassatly was working on the front-end of the rollout and was able to apply experiences from her previous internship to think about ways to get clinicians and nurses on board with the new procedure.

“That’s what makes me think that this theme is universal,” said Cassatly. “Administrator-clinician tension is found in so many healthcare settings.”

For Cassatly, who plans to work in the field of healthcare before pursuing a master’s degree in business administration, these relationships are what make the field of healthcare so fascinating.

“Being in a hospital, a healthcare program, is so fast-paced,” said Cassatly. “On top of medical administration being interesting to me, I love the dynamics of people.”