Work Redesign and the Balance of Control Within a Nursing Context

Within the nursing organization of four hospital wards, a new work design was introduced, which was primarily characterized by the delegation of responsibilities from head nurses to nurses and by the participation of patients. First, it was hypothesized that the participation of patients in health care would enhance their perception of both their own and the nurses' control over their stay in the hospital. Second, it was hypothesized that, in the perceptions of head nurses, nurses, and doctors, the new work design would enhance the perceived control of nurses and reduce the perceived control of head nurses over nursing care. Over 1000 patients, nurses, head nurses, and doctors completed questionnaires. The data support the hypotheses and the results are discussed in terms of participation and decentralization effects of work design changes. It was further observed that doctors evaluated some practical aspects of the new work design negatively, but measures have been taken to overcome these problems. Some organizational and management implications are briefly discussed.