Relationships among Span, Time Allocation, and Leadership of First-line Managers and Nurse and Team Outcomes

Comparisons of raw span (i.e., number of staff who report directly to a manager) within and across organizations can misrepresent managerial capacity to support staff because managers may not allocate the same amount of time to staff contact. The purpose was to examine the influence of alternative measures of managerial span on nurse satisfaction with manager’s supervision and on multidisciplinary teamwork. The alternative measures were (a) raw span as a measure of reporting structure and (b) time in staff contact as a measure of closeness of contact by the manager. The main effects of the alternative measures, leadership, hours of operation, and other covariates on outcomes were examined. The interaction effects of the alternative measures with leadership and hours of operation were investigated. The study framework was based on Open System Theory and the boundary spanning functions of managers. A descriptive, correlational design was used to collect survey and administrative data from employees, managers, and organizations. Managerial time allocation data were collected through self-logging and validated through observation. Acute care hospitals were selected through purposive sampling. For supervision satisfaction, the final sample size was 31 first-line managers and 558 nurses. For teamwork, the final sample size was 30 first-line managers and 754 staff. The Leadership Practices Inventory, the Satisfaction with my Supervisor Scale, and the Relational Coordination Scale were used. Hierarchical linear modeling was the main type of analysis conducted. Raw span interacted with leadership and hours of operation to explain supervision satisfaction. Teamwork was explained by leadership, clinical support roles, hours of operation, total areas, and non-direct reports, but not by raw span or time in staff contact. Large acute care hospitals can improve satisfaction with supervision and teamwork by modifying first-line management positions.