Organizational change: decentralization in hospitals.
Decentralization may be defined as the spread of power from higher to lower levels in a hierarchy. For hospitals, decentralization is an organizational change of special importance. Decentralization in hospitals may be accomplished through decentralization to departments; more general changes in organizational structure (reduction in the number of hierarchical levels and divisionalization); and, delegation of tasks. A framework for an analysis of decentralization status in hospitals is proposed in four main points; its starting point; the need for change in decentralization status; decentralization solutions; and, the need for review before a decentralization proposal is put into practice. Positive effects of decentralization may be obtained; but, to date, empirical investigations on the impact of decentralization in hospitals are few.
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Work Research Institute, Oslo, Norway.
D002497:Centralized Hospital Services; D003659:Decision Making, Organizational; D017408:Guidelines as Topic; D006302:Health Services Research; D006748:Hospital Departments / Q000458:organization & administration*; D006754:Hospital Restructuring / Q000379:methods* / Q000592:standards; D009936:Organizational Innovation; D010934:Planning Techniques; D017009:Professional Autonomy