Application of an Impact of Restructuring Scale to the Healthcare Sphere

Abstract

Job loss and job insecurity are frequently associated with today's widespread restructuring and downsizing of the workplace. The authors have developed an Impact of Restructuring Scale that quantifies the effects of restructuring in the healthcare sphere. The scale documents the effects of the resulting cutbacks, hospita mergers and hospital closings on two areas: quality of healthcare services and effects on staff. The study described in this article applies the scale to the healthcare sphere as reported in a sample of 1,363 nurses employed in hospitals that were being restructured. The nurses returned a self-report questionnaire in which they reported their reactions on a variety of measures designed to assess extent of restructuring initiatives, stressors, hospital support, job satisfaction and distress. Results showed that predictors of the impact of restructuring on nurses include restructuring initiatives undertaken by the hospital, deterioration of hospital facilities and services, work stressors (e.g., workload, bumping, use of generic workers) and social support. Hospital restructuring was also associated with lower job security, diminished job satisfaction and increase in depression, anxiety and somatization.