title: Flattening the hierarchy. A hospital streamlines managerial layers to meet market demands.
abstract: In the early 1990s it became clear to the leaders of St. Edward Mercy Medical Center, Fort Smith, AR, that the traditional ¿functional¿ model of organization, on which their hospital was based, did not allow it to meet new market demands. A core group of managers was formed to design a new organizational model and engineer the move toward it. Analyzing the hospital's structure, the core group found that it had too many administrative layers above too many specialized departments. In 1994 the group decided to adopt a span-of-control model of organization, which would give St. Edward a higher ratio of workers per manager. In 1995 the core group streamlined the hospital's managerial layers, deciding there would be no more than five. It reduced the number of supervisory positions by 36, including one vice president's slot. No manager was fired, though some were reassigned. St. Edward's reorganization continues at present. The new structure, which has cut personnel costs, fosters more open communication and empowers its workers, leading them to think in terms of ¿us and our hospital¿ rather than ¿me and my department.¿
authors.affiliation: St. Edward Mercy Medical Center, Fort Smith, AR, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Keith
mesh_terms: D001131:Arkansas; D002410:Catholicism; D003142:Communication; D003659:Decision Making, Organizational; D004465:Economic Competition; D006608:Hierarchy, Social; D006740:Hospital Administrators; D006745:Hospital Bed Capacity, 300 to 499; D006754:Hospital Restructuring / Q000458:organization & administration*; D016519:Hospitals, Religious / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D009936:Organizational Innovation; D011209:Power, Psychological