The impact of hospital structure and restructuring on the nursing workforce.
OBJECTIVE
Health systems throughout much of the world have been subject to 'reform' in recent years as countries have attempted to contain the rapidly rising costs of health care. Changes to hospital structures (restructuring) have been an important part of these reforms. A significant impact of current approaches to restructuring is the loss of, or changes to, nursing management roles and functions.


METHODS
Australian hospitals


BACKGROUND
Little evaluation has been undertaken to determine the impact of hospital structure and organisational restructuring on the nursing workforce.


CONCLUSIONS
There is some indication that nurses have experienced a loss of key management positions, which may impact on their capacity to ensure that adequate and safe care is provided at the ward level.
Centre for Health Services Management, University of Technology, Sydney, Australia. christine.duffield@uts.edu.au
Christine
C
Duffield
Mark
M
Kearin
Judy
J
Johnston
Joanna
J
Leonard
D001315:Australia; D017598:Efficiency, Organizational; D006301:Health Services Needs and Demand; D006754:Hospital Restructuring / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D009718:Nurse Administrators / Q000458:organization & administration; D024802:Nurse's Role; D015401:Nursing Administration Research; D009738:Nursing Service, Hospital / Q000458:organization & administration; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D020415:Personnel Downsizing / Q000458:organization & administration; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration