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Leading Practices for Addressing Clinical Manager Span of Control in Ontario Hospitals

How many direct reports should a hospital manager have? It’s a recurring question with no easy answer. The Ontario Hospital Association is out with a report addressing clinical management span of control in health facilities. The report provides an overview of the literature, shares the results of a span of control survey sent to chief nursing officers of Ontario hospitals, the executive directors of community care access centers, and the care directors of long term care homes in the province, and summarizes interviews with key informants.The survey looked at the impact of span of control on 9 dimensions:

  1. Effectiveness and frequency of communication
  2. Manager accessibility to staff
  3. Staff retention
  4. Staff attendance/absenteeism
  5. Staff injury rates
  6. Staff engagement
  7. Staff satisfaction
  8. Patient safety
  9. Patient satisfaction

Recommendations are made for defining span of control, leading practices are shared to address the issues, and measurement of the impact is discussed. Sample documents are appended.

Bottom line findings: There’s still no easy answer. The span of control depends on the frequency and the relationship between manager and staff, the complexity of the work, and the capabilities of both manager and staff.

Source: Leading practices for addressing clinical manager span of control in Ontario. Ontario Hospital Association, Feb. 2011. http://www.oha.com/Services/HealthHumanResources/Documents/Span%20of%20Control%20%28Final%29.pdf

Related sources:

Perspectives in staffing and scheduling annual survey of hours report – 2012. Labor Management Institute, 2013. http://lminstitute.com/products/ This annual nurse staffing benchmark report includes benchmarking data on nurse manager span of control.

Benchmarking hospital span of control: data, insights, and application framework. Advisory Board, HR Investment Center, April 2011. Report available only to subscribing members, but free brief summary is available at http://www.advisory.com/Research/Human-Resources-Investment-Center/Studies/2011/Benchmarking-Hospital-Span-of-Control

Neilson GL and Wulf J.  How many direct reports?  Harvard Business Review 90(4):112-119, Apr. 2012.  See blog post at https://aharesourcecenter.wordpress.com/2012/04/05/span-of-control-is-7-the-magic-number/

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

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