This commentary highlights the shift from span of control to span of accountability in nursing leadership, suggesting it may improve patient outcomes and aligns better with contemporary healthcare.
In the evolving landscape of healthcare, nurse managers are expected to lead across systems, influence patient outcomes, and drive strategic priorities, far beyond the traditional scope of direct supervision. Yet, the term “span of control” remains a default metric for evaluating their workload and effectiveness. Rooted in industrial-era management theory, this language no longer reflects the complexity of contemporary nursing leadership. These authors propose a shift to “span of accountability,” a more accurate, empowering, and future-ready framework. This commentary explores the theoretical rationale, practical implications, and strategic benefits of updating this lexicon to align with modern healthcare realities.
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Drenkard et al. (2025) studied this question.
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