Abstract
Many health care institutions have downsized in recent years for a variety of reasons including cost savings and the need to be proactive in restructuring the organization for more effective performance. In a downsized organization, top management must develop new strategies to enable line managers at all levels to operate effectively. New policies for human resource strategic planning, selective hiring, employee empowerment, training and development, reduction of status distinctions, sharing of appropriate information with employees, and paying for performance must be implemented.