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Writing in the September 2004 Journal of Nursing Administration, Deb Cathcart, director of
nursing administration at Minneapolis-based Fairview University Medical Center, and colleagues
discuss their study showing that mangers’ larger spans of control negatively influence staff
engagement, which they define as “the degree to which an employee is fully committed to
bringing his/her best efforts in his/her role every day.” The authors note that in an effort to reduce
costs many health care institutions eliminate management positions, increasing the span of
control for remaining managers but possibly damaging staff engagement. Although a number of
studies have shown the negative effects of large spans of control, the authors state that theirs is
the first study to assess the impact on staff engagement. Based on the study’s results, Fairview
Health Services added management positions in four patient care areas. One year later, all four
units saw improved mean engagement scores, with one unit’s scores improving by 14%.