New method to empower healthcare managers

A new method that measures managers' responsibilities and workload can improve the work environment and patient safety in healthcare.
The method is introduced in a doctoral thesis in health sciences.

First-line managers in hospital wards have a complex task with extensive responsibilities that affect the staff's work environment and patient safety. In a new doctoral thesis from the University of Gävle, researcher Karin Lundin introduces a new way of measuring these managers' so-called span of control - a tool that can help the healthcare sector understand and improve the managers' conditions.

"These managers often bear the heavy responsibility of reconciling organizational goals, staff needs and patient safety in their daily work. At the same time, many find it difficult to influence their situation and experience frustration that management does not always see their needs and those of the organization", says Karin Lundin, PhD in healthcare science.

The situation of first-line managers is often complex and difficult to highlight fairly.

"It is common to look at the number of staff as a measure of managers' responsibilities and workload, and how well a department is equipped to cope with its mission. This gives a simplified picture of reality", says Karin Lundin.

The new method takes into account, among other things, the level of experience of staff, the structure of the workplace and the location of the units for which each manager is responsible.

A large span of control often means high complexity, which, according to the thesis, risks leading to a poorer work environment and reduced quality of care. At the same time, the results show that the right support and networks can mitigate the effects - and that managers who are given the right conditions also create good conditions for their staff.

"Most hospitals and regions have structures that offer leadership training, mentoring, and support functions such as managerial support or deputy managers. But sometimes it becomes blunt. Someone described management introducing a reform that "everyone should have a deputy manager. But this may not be appropriate for the individual manager or unit. Managers are calling for more flexibility, and they described how a particular support function can become a 'disruptive function' instead".

The research not only provides a picture of the challenges faced by managers, but also concrete tools for the development of healthcare organizations. The new span of control measurement tool can be used to map the current situation, discuss the need for change and create more sustainable work environments.

The thesis is based on survey responses from 331 healthcare workers and 35 first-line managers in 38 hospital units from randomly selected departments across Sweden.

"Given the major changes taking place in healthcare, it is important to be able to monitor the workload of managers. My research shows that this is possible and necessary if we want to ensure both the work environment and the quality of care in the future", says Lundin.

Link to the thesis External link.