The fourth edition of this very successful and highly regarded textboo k introduces, updates, or explores with freshened emphasis: restructur ing and the delivery of nursing services, integrated delivery systems, the managed care environment, subacute care, patient-focused care, ca se management, and interdisciplinary teams. Changes in management styl e are covered including participatory staff involvement, outcome-based decision making, statistically based evaluations, strategic planning, new developments in QI, advances in computer technology and informati on management, the increased complexity of ethical issues, and the cha nging human resources scene.