Organizational Structure and Culture

 Organizational Structure and Culture

Organizations should have specific types of structure not only to maintain their organization, but also to foster employee development and client satisfaction and safety. A proper nursing organizational structure provides a formal framework through which the management processes take place within the organization (Keyton, 2011). That is, an effective organizational structure provides communication networks, effective work systems, and identity to the employees. The organizational structure for healthcare centres should foster job satisfaction and create client centered care. This paper outlines the organizational structure for Integrated Care and Nursing Home, closely focusing on how the structure create a supportive environment for client centered care, the main information systems, and how the organization integrates the community’s social and cultural influences into the care delivery.

Organizational structure refers to the management levels within an organization (Keyton, 2011). The levels allow effective and efficient management of various departments. However, with the patients’ lives in its hand, Integrated Care and Nursing Home has a vertical organizational structure with several management layers. Most of the hospital’s staffs work in specific, narrow, and low-authority roles. The hospital’s management is designed to ensure that individual staffs do not interfere with the hospital’s system because of the chain of command that they are supposed to adhere to. The vertical organizational structure creates a supportive environment for client centered care not only by ensuring that there is a clear distinct chain of command, but also ensuring that the tasks are conducted efficiently and effectively through close supervisor within each department.

In addition, the hospital has information services including document and process information. These assist in keeping medical records, billing, and collection of various charges for services, admissions, facilitating health education, and accessing human resources. According to Keyton (2011), communication among workers especially in healthcare accounts for most information flow and communication errors thereby leading to a high clinical mortality and morbidity rates. Nonetheless, the Integrated Care and Nursing Home uses telecommunication system supplemented with portable phones for each department to avoid such incidences.

All Integrated Care and Nursing Home’s departments hold regular face-to-face meetings, both planned and impromptu, notice boards, and notes at ward desks. On the other hand, the employees use informal communication channels such as notes and gossip. The informal communication involves the social and personal relationships among employees (Jablin & Putnam, 2001). The channels provide social satisfaction and helps employees to meet their individual objectives. Owing to the fact that informal communication is a key aspect to the management, the Integrated Care and Nursing Home is aware of the existence of informal communication, understand its operational techniques, and deploys it to achieve the healthcare goals.

Overall, the organizational culture is critical in every aspect of the company’s decision-making (Jablin & Putnam, 2001). For instance, whenever healthcare organizations focus more on profits, they are likely to lose their integrity. The Integrated Care and Nursing Home promotes a thoughtful culture and makes decisions based on the best services for the patients, the staff, and the entire community. However, the hospital faces pressure from the finance department to control costs partly due to the increasing cost of drugs and supplies. Nonetheless, such pressure has never prompted the management to make unethical decisions. Some departments also face challenges managing different population and the management’s expectation for clients to be treated with care.

Integrated Care and Nursing Home has an administrative organizational chart with directors in top-management down to the physicians at the bottom. The directors are followed by the executive including the chief executive officer, chief nursing officer, chief medical officer, chief informational officer, chief financial officer, and chief operational officer. The executive officers form the core management often implement decisions made by directors on their (executive officers) day-to-day operations of the hospital.

Thereafter, the department administrators follow within the hierarchy reporting to the executive. The departments include those of patient care such as labor and delivery, orthopedics, and emergency department. However, there are also non-patient-care department including food billing and services. There is also the clinical department that has many staffs because it has high supply and purchasing needs and regulations which nurses must comply with. Therefore, the administrators have assistants to oversee the numerous complex operations.

Below the department administrators there are patient care managers who directly oversee the patient care. These include director of rehabilitation services and the supervising physician, and the nurse manager with people under them assisting on patient care. The patient care managers ensure that the staffs act appropriately, address all duties, and give the best care while complying with legal and hospital’s standard. Similarly, the patient care level of management oversees basic human resource and schedule functions for the employees. The last category includes service providers including such as laundry workers and cooks with specific duties and job descriptions which the hospital requires them to handle to ensure the patient’s health and safety. Although each individual reports to specific functions and authorities within each department, whenever other functions are required which are out of a particular department, a staff from a different department is called to assist thus ensuring effective and efficient service deliver to the clients.

The Integrated Care and Nursing Home’s organizational structure describes the duty arrangement within each department. Keyton (2011) describes such concept as designed to maintain command, reinforce authority, and provide formal reporting lines. The hospital has a vertical organizational structure with a clear relationship with all the staffs. That is, each department has a single reporting line that is formally recognized. According to Keyton (2011), formal reporting lines allow staffs to have independence and be accountable for their actions and outcomes. However, sometimes the informal organizational structures have informal reporting lines within the hospital. Whenever the two lines (formal and informal) cross, departments such as administration are involved in the care management and executive areas. Consequently, there arise power and control issues within the organization. Nonetheless, the hospital continues to ensure that, decisions are made at departmental levels and communicated formerly through single reporting lines down the structure.

It is important to understand how the community thinks about illness and health and individual behaviors and habits which influence health, how the community perceives the healthcare practitioners and their actions, and how culture interacts with the environment to affect healthcare delivery (Keyton, 2011). The Integrated Care and Nursing Home recognize the community’s assumption about issues such as mental health and childbirth among others thereby considering such assumptions during healthcare delivery. For instance, the staffs concerned with labor and delivery understand the community’s assumption regarding the role of medicine in reproductive health, the number of children a family should have, and where women should have their babies. In most cases, such ideas are integrated during healthcare delivery programs within the community.

On the other hand, social factors involve factors which distinguish major differences between groups of people within the community (Dziegielewski, 2003). These include religion, occupation, income, education, ethnicity, and race among other factors. Understanding these factors often assists the hospital to plan and deliver healthcare services. For instance, such factors assist in understanding the most vulnerable communities and group of people thereby making an informed decision prior to healthcare delivery.

Generation refers to an identifiable group that share birth years, location, age, and significant life events at developmental stages (Miles, Furino, & Schaie, 2006). The Integrated Care and Nursing Home’s workplace consist of different generations thereby leading to variations in employees’ career stage and lifestyle. These and other differences are often challenging for the management to standardize the organizational values and norms or change from one operational standard to another. Similarly, sometimes the hospital experiences declined ethics and loyalty toward department heads at the workplace due to generational differences. Nonetheless, the elder employees are often loyal to their team leaders; in fact, most young workers value their relationship with co-workers than their relationship with their department heads and hospital as a whole. However, the hospital has introduced integrated training programs to overcome such challenges.

Overall, the Integrated Care and Nursing Home has a suitable structure that facilitates proper coordination of management activities to ensure patient safety and care. The hospital has information system and uses good communication methods thereby ensuring that there is smooth flow of information. Although the hospital faces social and cultural challenges, such factors are systematically integrated within the organization thereby improving healthcare delivery. Although the hospital’s culture is negatively affected by generational differences, the organization has devised training programs to address these challenges.

References

Dziegielewski, S. F. (2003). The changing face of health care social work: Professional practice in managed behavioral health care. New York: Springer Pub. Co.

Jablin, F. M., & Putnam, L. (2001). The new handbook of organizational communication: Advances in theory, research, and methods. Thousand Oaks: Sage Publications.

Keyton, J. (2011). Communication & organizational culture: A key to understanding work experiences. Los Angeles: SAGE.

Miles, T. P., Furino, A., & Schaie, K. W. (2006). Aging health care workforce issues. New York: Springer Pub. Co.

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