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  1. Bryan, Yvonne E. PhD, RN
  2. Hitchings, Kim S. MSN, RN
  3. Fuss, Ann Mae MSN, RN, CCRN
  4. Fox, Mary Agnes MSN, RN
  5. Kinneman, Mary T. MSN, RN
  6. Young, Mark J. MD


Critical care has enjoyed unobstructed growth during the past two decades; however, to remain viable, process and role changes are pivotal to ensuring continued quality, cost-effective, and efficient care. In this article, the second in a two-part series, the authors describe restructuring efforts, inclusive of their measurement and evaluation strategies, within four critical care units at an acute care, tertiary institution. Special emphasis is placed on the process, the authors' observations, and lessons learned to date. Part 1 (September 1998) presented evaluation data of the effects of hospital restructuring on patient and nurse satisfaction, costs of care, and clinical quality in four medical-surgical units.