Restructuring to create a climate for clinical excellence for nursing

A fundamental responsibility and urgent requirement of health care leaders is to create and develop organizational structures and environments that support nurses and nurses' work--whose ultimate goal is to support the analytical, interpersonal and technical skills that combine with knowledge to produce wise and thoughtful caring. The ways in which structure can facilitate and enhance care delivery often are not clearly understood. This article describes a strategic reorientation and reorganization of the Department of Nursing of the Sir Mortimer B. Davis Jewish General Hospital in Montréal, designed to meet the needs of patients, nurses and the hospital more effectively.