Journal article
Allied health in the matrix: governance structures and workforce experience across two hospital eras
Journal of Health, Organization and Management, Vol.40(9), pp.171-191
2026
Abstract
Purpose
This study contributes to international debates in health services management by examining how clinical matrix governance structures shape the workplace experiences of allied health professionals (AHPs) in public hospital bed-based services. Through a comparative analysis of two Australian hospital case studies conducted 26 years apart, it explores how and why governance tensions persist or evolve across institutional eras.
Design/methodology/approach
Two qualitative case studies with comparable methodologies and contexts were analyzed. Each involved semi-structured interviews with managers and senior clinical leaders across allied health, nursing, medicine and administrative domains. A cross-case comparative analysis assessed how changes in organizational structure shaped AHPs' experiences and perceptions of their work environments.
Findings
Sustaining a clinical matrix structure in acute and subacute hospital bed-based settings imposed complex governance demands that adversely impacted human resource management, operational requirements, budgetary control and professional morale among AHPs. These tensions were consistently associated with reduced job satisfaction and perceived inefficiencies.
Research limitations/implications
The research is 26 years apart, but not a true longitudinal study, but more of a comparison decades apart. One limitation is that the study was conducted with managers and leaders only and did not gain the perspectives of front-line clinical staff.
Practical implications
By comparing governance in specific environments across decades, this research provides hospital executives and policymakers with evidence-based insights into the risks and opportunities of clinical matrix structures for AHPs and offers actionable recommendations to enhance workforce sustainability, operational efficiency and patient care outcomes.
Social implications
The allied health workforce often feel less valued than medical and nursing, particularly during re-structures in which they are placed into design's that often do not meet their needs from a governance perspective, including their social identity needs such as professional identity. This is often disrupted and overlooked by administrators during organizational re-design processes.
Originality/value
Despite widespread adoption of matrix models, their long-term implications for allied health governance and workforce well-being remain underexplored. This study offers rare insight into how structural design affects AHPs' morale, coordination and professional voice, highlighting the need for governance models that better align with allied health's operational and professional requirements.
Details
- Title
- Allied health in the matrix: governance structures and workforce experience across two hospital eras
- Authors
- Gemma Turato (Corresponding Author) - University of the Sunshine CoastRosalie Boyce - The University of Queensland
- Publication details
- Journal of Health, Organization and Management, Vol.40(9), pp.171-191
- Publisher
- Emerald Publishing Limited
- Date published
- 2026
- DOI
- 10.1108/JHOM-04-2025-0212
- ISSN
- 1758-7247
- Copyright note
- © Gemma Turato and Rosalie Boyce. Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at Link to the terms of the CC BY 4.0 licence.
- Organisation Unit
- School of Health
- Language
- English
- Record Identifier
- 991223827002621
- Output Type
- Journal article
Metrics
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- Collaboration types
- Domestic collaboration
- Web Of Science research areas
- Health Policy & Services