Firstly, and at the risk of being massively disingenuous, I don't have a direct answer. It would be up to the community to decide. It's not for me to assume authority. Now, that said, in case this invites accusations of analysis paralysis
I think most of these are questions to which we already have answers, it's just a question of organising things more effectively. Without bosses and wage labour there's no need to have huge long hours, crazy shift patterns etc. Work loads can be shared amongst citizens more fairly. This creates a positive feedback loop in society where people feel more engaged, more in control, and less stressed.
My initial question was in respect of the practicality of having a vote on every issue. But that I think has been addressed.
The issue of people being in charge comes down, again, to valid authority. So who plans the construction of a hospital is the person with the expertise, which itself can be discussed by the community. Noone gets to just decide 'i'm going to build a hospital, screw you!'. But his authority is based solely on his knowledge of architecture and the remit extends only as far as getting the job done. It doesn't give him or her the right to control other people's lives and people can freely associate as they wish. If that begs the question, what happens if noone wants to freely associate, then the simple answer is the people don't get their hospital. That then addresses the notion of responsibility I mentioned above. If people need a hospital then people need to work together to create one, but that will be done without exploitation and through people coming together to address a need, without exploiting others.
However, you are also begging a question when you refer to 'country wide level'? How big is the community? Will countries even exist?