Size does matter - span of control in hospitals

Area of Science:

• Healthcare Management
• Organizational Behavior
• Nursing Leadership

Background:

• Healthcare organizations face increasing span of control (SOC) due to centralization, mergers, and cost-cutting measures.
• This trend potentially diminishes leadership capacity within hospitals.
• Limited qualitative research exists on the specific consequences of large SOC in hospital settings.

Purpose of the Study:

• To explore the impact of a large span of control (SOC) on hospital staff and their frontline leaders.
• To understand the challenges and benefits associated with increased SOC in inpatient wards.

Main Methods:

• A qualitative, explorative case study approach was employed.
• Data was collected from three large inpatient hospital wards.

Main Results:

• Nursing staff and frontline leaders reported difficulties with leader visibility and role clarity.
• Challenges included maintaining overview, coordination, goal setting, follow-up, and leader accessibility.
• Conversely, large wards were found to offer increased flexibility and professional development opportunities.

Conclusions:

• Decision-makers should carefully consider the implications of SOC on leadership capacity and staff experience.
• Further research is needed to qualitatively investigate the nuanced effects of large spans of control in hospital environments.