Leadership Span of Control

Diane Doran, RN, PhD, FCAHS Professor, Scientific Director Nursing Health Services Research Unit Lawrence S. Bloomberg Faculty of Nursing University of Toronto

University of Toronto

Funding Acknowledgement

Canadian Health Services Research Foundation Ministry of Health and Long-Term Care Nursing Effectiveness, Utilization, and Outcomes Research Unit

Span of Control Defined „

Span of control may be described as “the area of activity, number of functions or subordinates, etc., for which an individual or organization is responsible” (Oxford University Press, 2005).

Historical „

„

During the industrial revolution, classical theorists debated the maximum number of staff whose work and interactions the manager could supervise, direct, coordinate, and control (Graicunas, 1937; Gulick, 1937; Urwick, 1937). This approach to span of control, also known as ‘limited span’, delimits the maximum number of workers that one superior can oversee (Van Fleet & Bedeian, 1977).

Historical „

Subsequently, span of control was theorized in relation to organizational structures, with wider and narrower spans deemed appropriate at lower and higher organizational levels respectively (Van Fleet & Bedian, 1977).

„

Greater diversity in the number of specialties supervised has been associated with narrower spans for lower level managers (Dewar & Simet, 1981; Meier & Bohte, 2003).

Span of Control Theory Author

Span of Control

Setting

Results

Average

Range

20

9-34

Significant negative

2. Alampay & Chemical Beerh, 2001 Schools 3. Meier & Bohte, 2000 Libraries 4. Cogliser & Schriesheim, 2000 5. Green et al., Libraries 1996

47

12-110

15

9-19

Significant negative Significant negative

10

2-26

Negative but not significant

6

1-19

Significant negative

6. Schriesheim et al., 2000

11

5-21

Negative but not significant

1. Gittell, 2001

Airlines

Banks

Relationship

Factors Influencing Span of Control Work

Manager

Narrow

Novice Variable Basic Complex qualification Interdependent Controlling leadership style Broad

Routine Independent Automated Computerized feedback

Nancy New, 2009

Experienced Highly skilled Able to delegate Transactional or transformational

Factors Influencing Span of Control Workers Narrow

Broad

Organization

Inexperience Poorly skilled Need for professional development

Experienced Highly skilled Well-qualified

Unstable Complex structure Weak management support Stable Flat structure Empowering administration Strong management supports

Nancy New, 2009

Application to Span of Control in Health Care – Ottawa Hospital, Ontario, Canada

Unit Focus … Complexity … Material Management Staff Focused … Volume of staff … Skill level/ autonomy of staff … Staffing stability … Diversity of staff

Program Focused … Diversity … Budget/statistical

Canadian Context „

The 1990’s saw downsizing and restructuring in many Ontario hospitals

„

Many Nurse Manager positions were eliminated

„

Delayering of management & supervisory positions in health care

„

Increasingly heavy managerial workloads & greater numbers of direct reports

Canadian Context Associated with human resource problems „ Limited research on Health Care Leadership „ Prompted researchers at the Faculty of Nursing at U of T to explore which leadership style and span of control would optimize nurse, patient and organizational outcomes „

12

The Research Objectives „

The project examined „ The influence of the manager’s leadership style on outcomes: …Nurses’ job satisfaction …Patient satisfaction …Unit staff turnover „ The influence of the manager’s span of control on outcomes „ Which particular leadership style contributed to optimum outcomes under differing spans of control

Leadership Theory „ „

„

Defining Leadership Transformational Leadership Theory Four leadership styles with varying effect on staff performance „ Transformational „ Transactional „ Management-by-exception „ Laissez faire Contingency Theory

Theoretical Framework Span of Control

Leadership Style • Transformational • Transactional • Mgmt by exception • Laissez faire

Performance •Job satisfaction •Turnover •Patient satisfaction

Research Method/Measures „

„

Method … Design: Descriptive Correlation Design … Setting: 7 Hospitals, 51 Units … Sample: 41 Managers, 717 Nurses, 680 patients Measures … Multifactor Leadership Questionnaire … McCloskey Mueller Satisfaction Scale … Patient Judgments of Hospital Quality … Nurse Demographic Questionnaire … Manager Questionnaire

Nurses’ and Managers’ Age and Experience Nurses

Managers

Mean

Range

Mean

Range

40

20 - 64

45

30 - 59

7

1 - 35

5

1 - 25

Hospital Experience

12

1 - 38

7

1 - 25

Total Experience

16

1 - 43

10

1 - 30

Age Unit Experience

Nurse Education Level

Manager Level of Education

Study Findings: Span of Control Number in Sample

Mean

Range

41

81

36 - 258

40

77

36 - 151

Nurses' Job satisfaction

717

3.2

1.0 - 4.9

Patient Satisfaction

680

2.2

1-5

Unit turnover rate

51

.18

.10 - .63

Study Variables Span of control of 41 managers Span of control of 40 managers* (*unit of 258 excluded)

Nurses’ Job Satisfaction Job satisfaction 80

60

Frequency

40

20

0 4.

4.

4.

4.

3.

3.

3.

3.

2.

2.

2.

2.

1.

1.

1.

1.

88

63

38

13

88

63

13

38

88

38

63

88

13

63

13

38

Job satisfaction

Study Findings: Patient Satisfaction Patient Satisfaction 140

120

100

80

60

Frequency

40

20 0 1.2

1.6

2.0

Patient Satisfaction

2.4

2.8

3.2

3.6

4.0

4.4

4.8

Leadership Styles and Span of Control on Job Satisfaction •

• •

Leaders who used a transformational or transactional leadership style had more satisfied staff Leaders who used a management by exception leadership style had less satisfied staff Span of Control moderated the relationship between leadership style and job satisfaction „ Wide spans of control decreased the positive effect of both transformational and transactional leadership styles, and „ Increased the negative effect of both management by exception and laissez-faire leadership styles on staff satisfaction

Leadership Styles and Span of Control on Patient Satisfaction „ „ „

Patient satisfaction was higher on units where managers used a transactional leadership style Patient satisfaction was lower on units where managers had wide span of control A wide span of control reduced the positive effect of transformational and transactional leadership styles on patient satisfaction

Leadership Styles and Span of Control on Staff Turnover „ „

„

Turnover definition Leadership styles and Turnover … Units with managers who used a transformational style of leadership had lower levels of staff turnover Span of Control and Turnover … Units with managers who had a wide span of control had higher levels of staff turnover

Recommendations „

What do Health Care Organizations need to do? … Design & implement management training on effective leadership styles … Develop guidelines regarding the number of staff a manager may effectively support & lead

RELATIONSHIPS BETWEEN SPAN OF CONTROL, TIME ALLOCATION, AND LEADERSHIP OF FIRST-LINE MANAGERS AND NURSE AND TEAM OUTCOMES

Raquel Myers Lawrence S. Bloomberg Faculty of Nursing University of Toronto

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Meyer, R. (in press). Span of management: Concept analysis. Journal of Advanced Nursing.

Past Research „

Often over-emphasizes personal attributes of managers without considering organizational context & demands

„

Relationships between managerial work & outcomes have yet to be examined in depth

„

Managerial work is often described in terms of management functions or roles & is measured as ‘span of control’

„

Multiple definitions of span are used

29

Problem Statement

30

„

Span is typically measured as a ratio: number of direct report employees per manager

„

A ratio assumes “standard” staff, managers & environments

„

Comparisons of number of direct report staff per manager within & across organizations can misrepresent managerial capacity

Alternative Span Measures „ „ „

Span adjusted for time spent in human resource activity Span adjusted for time spent in staff contact Raw span (# of direct reports per manager) :KDW"

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31

Main Goal

32

„

To what extent do alternative measures of span explain variation in teamwork & nurse satisfaction with manager’s supervision?

„

The three alternative span measures were: … Raw span (# of direct reports per manager) … Span adjusted for time spent in human resource activity … Span adjusted for time spent in staff contact

Setting and Sample „

Setting …Acute Care Hospitals

„

Sample …31 first-line managers …754 staff nurses

Summary of Span Measures Span measure

Metric

Raw span

Number of direct reports

Mean 86.6

Range 29 – 174

Time adjusted span for human resource activity

Minutes per direct report

2

.51 – 5.6

Time adjusted span for staff contact

Minutes per direct report

2.6

.78 – 6.5

Leadership Styles and Span of Control on Job Satisfaction • • •

• •

Satisfaction with supervision positively associated with increased job satisfaction The effect of Raw span varied with managers’ hours of operation When managers were assigned compressed or mixed hours of operation, under low raw span, satisfaction was higher with higher leadership. Under high raw span, satisfaction was lower with higher leadership. Thus when managers were assigned compressed or mixed hours of operation, they could not overcome high raw spans to positively influence nurse satisfaction with manager’s supervision.

Leadership Styles and Span of Control on Teamwork Neither raw span nor time in staff contact explained between-manager variation in teamwork. „ Teamwork was positively associated with leadership, compressed and mixed hours of operation, and clinical support roles. „

Leading Practices for Addressing Clinical Manager Span of Control in Ontario, Canada

Ontario Hospital Association

Perceived Impact of Span of Control on Dimensions of Organizational Performance Quality indicator

% Managers Reporting Span of Control has Negative Impact

Manager accessibility to staff

35%

Communication effectiveness

31%

Staff engagement

23%

Staff satisfaction

21%

Staff absenteeism

19%

Staff retention

10%

Client/ patient safety

8%

Client / patient satisfaction

7%

Staff injury rates

3% Total n = 524

Qualitative Comments “The

span of control is too large for me – I have over 90 staff to do performance appraisals on with no Program Manager at all; the constant interviews of new staff, and dealing with daily “fires” prevent any strategy thinking”.

Qualitative Comments “In a small organization… there are not layers of support (administrative assistant, consistent supervisors). You do the work of a supervisor, manager, and director”.

Qualitative Comments

“When we cover for other managers that have multiple departments the day is usually spent putting out fires and trying to cover holes in schedules. It is difficult to do my desk work on many days”.

Qualitative Comments “I feel that my job has drained the life out of me. As a front line manager I find that in order to meet the needs of the organization, I have to let my staff down and vice versa”.

“A large span of control can allow for standardization of best practices … allows for improved efficiencies and a broader perspective for leaders”.

“But there needs to be appropriate amount of clinical supervision and support at point of care”.

Strategies Implemented to Alleviate Impact of Wide Span of Control Strategy

Strategy

Manager access & visibility

More face-to-face communication

Performance appraisal

Reduce span of control

Manager/ administrative walkabouts

Administrative supports (e.g., nurse educator, charge nurse)

Staff involvement in decision making

Conducting staff satisfaction surveys

Appreciation and recognition

Appreciation & recognition

Manager flexibility

Increased education funding and opportunities

Staff forums/ town halls

Regular unit meetings

Use of email/ other IT tools for communication Total n = 524

Danish Context „

Span of control on Danish wards (50-70) is slightly lower than that observed in Ontario hospitals (average 81-87); both are increasing.

„

Challenges for nurse managers are similar – communication and contact with staff, work strategically.

Recommendations for Managing Wide Span of Control „ „ „ „ „

Effective meeting and feedback culture Organize staff members in smaller teams Focus on increasing opportunities for communication Develop clinical infrastructure support Develop administrative operations infrastructure support for responsibilities that can be delegated

Recommendations „

Develop nursing leadership at the point … Clinical

experts … Program coordinators for specific populations … Clinical nurse supervisor role „

Administrative infrastructure support … Administrative

assistant for payroll, secretarial, personnel paperwork … Supervision of non-clinical staff such as unit clerks

Recommendations „

Unit bases shared governance … Staff

„ „

engaged in decision making role

Reduce span of control When managers oversee multiple groups or units with the hospital, there should be similarities between the groups or units (Layman, 2007)

References „ „ „ „ „ „ „ „ „ „ „ „ „ „ „ „ „ „ „

Bass, B. (1985). Leadership and performance beyond expectations. NY: The Free Press. Bass, B. (1998). Transformational leadership: Industrial, military, and educational impact. Mahwah, NJ: Lawrence Erlbaum Associates, Inc. Bass, B., & Avolio, B. (1990). The implications of transactional and transformational leadership for individual, team, and organizational development. Research in Organizational Change & Development, 4, 231-272. Bass, B., & Avolio, B. (2000). Multifactor leadership questionnaire. Redwood City, CA: Mind Garden, Inc. Bryman, A. (1992). Charisma and leadership in organizations. London, Sage. Burke, R. (1996). Unit size, work experiences and satisfactions: An exploratory study. Psychological Reports, 78 (3), 763-768. Densten, I., & Gray, J. (1998). The case for using both latent and manifest variables to investigate management-by-exception. The J of Leadership Studies, 5(3), 80-92. Gittell, J. (2001). Supervisory span, relational coordination and flight departure performance: A reassessment of postbureaucracy theory. Organization Science, 12(4), 468-483. Gulick, L. (1937). Notes on the theory of organization. In L. Gulick & L. Urwick (Eds.), Papers on the science of administration (pp. 191-195). NY: Institute of Public Administration, Columbia University. Hater, J., & Bass, B. (1988). Superiors evaluations & subordinates perceptions of transformational and transactional leadership. J of Applied Psychology, 73, 695-702. Hechanova Alampay, R., & Beehr, T. (2001). Empowerment, span of control, and safety performance in work teams after workforce reduction. J of Occupational Health Psychology, 6(4), 275-282. House, R.J., & Aditya, R.N. (1997). The social scientific study of leadership: quo vadis? J of Management, 23(3), 409-474. Lowe, K., Kroeck, K., & Sivasubramaniam, N. (1996). Effectiveness correlates of transformational and transactional leadership: A meta-analytic review. Leadership Quarterly, 7(3), 385-425. Meier, K., & Bohte, J. (2000). Ode to Uther Gulick: Span of control and organizational performance. Administration & Society, 32(2), 115-137. Mueller, C., & McCloskey, J. (1990). Nurses’ job satisfaction: a proposed measure. Nursing Research, 39(2), 113-117. Rubin, H., Ware, J. E., & Hayes, R. D. (1990). Patient judgments of hospital quality questionnaire. Medical Care, 28(9), 22-43. Song, R., Daly, B., Rudy, E., Douglas, S., & Dyer, M. (1997). Nurses’ job satisfaction, absenteeism, and turnover after implementing a special care unit practice model. Research in Nursing & Health, 20, 443-452. Urwick, L. (1956). The manager's span of control. Harvard Business Review, May-June: 39-47. Yammarino, F. J., & Bass, B. M. ((1990). Transformational leadership at multiple levels of analysis. Human Relations, 43, 975-995.