Revitalizing decision making at the middle management level.

If health care organizations are to meet future challenges, greater attention needs to be given to the role and function of middle management. Middle management traditionally has tended to suffer from benign neglect vis-à-vis attention given to top executives in the management of strategic change. This article explores some of the factors that affect the ability of middle managers to operate, identifies some of the problems they face, and suggests some guidelines for executives and middle managers that should enhance decision making at the middle management level of the organization.