Measuring staff outcomes following reorganization: participation in decision making, autonomy, and job satisfaction

This longitudinal descriptive study was designed to evaluate staff outcomes at one hospital in Vancouver, British Columbia as a result of implementing an organizational model designed to enhance staff participation in decision making (PDM). The specific outcomes of interest were staff perceptions regarding PDM, autonomy, and job satisfaction. The purposes of the investigation were to explore the impact over time on the three variables, to examine the interrelationships among the variables, and to assess the effects of selected demographic characteristics on staff perceptions regarding the variables. A convenience sample of approximately 150 nursing staff completed a questionnaire at three distinct time periods: one year, two years, and three and one-half years after the initial implementation. Over the three-year period, the means for the three variables did not change significantly. Nurse managers experienced greater autonomy than did staff and were the group most vulnerable to organizational change. The interrelationships among the three variables were positive, but the strength of the relationships was inconsistent. The relationship between PDM and job satisfaction was moderately strong and comparable to that identified by other researchers. Autonomy and job satisfaction were positively, but weakly, correlated as were PDM and autonomy. The effects of demographic characteristics on the three variables are inconsistent and variable. Employment position, years experience and type of shift affected PDM, while employment position and type of shift affected autonomy. Employment position was the only nurse characteristic that significantly affected job satisfaction. The findings of this study do not support the popular notion that a participative organizational model will automatically increase PDM, autonomy, or job satisfaction. Such effects seem to require a change in more than structure. The study hospital did not implement any initiatives other than structural change and did not successfully increase staff perceptions regarding PDM, autonomy, and job satisfaction. The implication of the findings for nursing administration, and social and health policy and further research are discussed.Applied Science, Faculty ofNursing, School ofGraduat