Nurse Leaders' Perceptions of Influence of Organizational Restructuring on Evidence-Informed Decision-Making.
OBJECTIVE
To describe how organizational context and restructuring influenced nurse leaders' use of evidence in decision-making in their management practice.


METHODS
Qualitative descriptive study. Fifteen leaders at executive and front-line manager levels in one organization were interviewed using a semi-structured format.


RESULTS
Inductive content analysis generated five main themes: leaders strove to keep relationships that preserve best decision-making ability; and sought the best knowledge to inform their decisions. However, a context of constant change; more scope; less autonomy; and decisional inertia in a sea of change had profound effects on their ability to employ evidence in decision-making.


CONCLUSIONS
Evidence-informed decision-making is a dynamic social process highly influenced by political instability in work environments. Organizational restructuring creates threats to common decision-making strategies, including information flow, relationships and priority setting. Healthcare restructuring is now a global constant, and there is a need for hospital leaders to understand and mitigate the effect restructuring has on the ability of leaders to engage in evidence-informed decision-making. Strategies are proposed to manage uncertainty and support nurse leaders in their evidence-informed decision-making to deliver quality health services. This research provides an in-depth examination of how evidence-informed decision-making is influenced in the context of instability and uncertainty due to ever-present organizational restructuring.
Associate Professor, Faculty of Nursing, University of Alberta, Edmonton, AB.
Judith A
JA
Spiers
Patient Care Manager, Alberta Health Services, Edmonton, AB.
Eliza
E
Lo
Senior Lecturer, School of Nursing & Midwifery, University of South Australia, Adelaide, SA, Australia.
Anne
A
Hofmeyer
Professor and Centennial Professor, Faculty of Nursing, University of Alberta, Edmonton, AB.
Greta G
GG
Cummings
D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D009718:Nurse Administrators; D009936:Organizational Innovation; D010465:Perception; D036301:Qualitative Research