Describe the common features that define organizational structures #1
- Chain of command
• Path of authority and accountability of the organization (who reports to who and when)
o Scalar process
Vertical growth (the more steps there are the more centralized the decision making is)
o Functionalization
Horizontal growth (different kinds of duties at the same level)
Describe the common features that define organizational structures #2
2. Span of control • Refers to number of people a manager is supervising o Narrow/short Few people/tasks 3-5 subordinates Allows for more control o Broad/wide Many people/tasks Decreased control
Describe the common features that define organizational structures #3
- Service line features
a. Line function (solid lines)
• Hierarchy of personnel that is from executive to workers at bottom
• Involves direct responsibility to meet objectives
• Have authority for decision making
b. Staff function (broken lines)
• May assist line positions, provide support, advise and control
Understand the implications of a decentralized organizational structure vs a centralized structure (centralized)
- Centralized
Location where decisions are made
Usually only by a few individuals at the top of the organization
Decisions made by a few people and communicated down
Authority is formalized
• Advantages – allows for close coordination and control of workers – highly productive – works well where close coordination and rapid change is occurring
• Disadvantages – communication can be very slow and difficult due to number of levels it has to go through – workers tend to get boss oriented – very little individual thinking – adjustment to change is very slow and implementation can be very difficult – very expensive structure because so many managers
Understand the implications of a decentralized organizational structure vs a centralized structure (decentralized)
- Decentralized
Decisions are made by the professionals that are doing the work
Fewer layers to work through
Decision making more delegated and spread out
Easier to work within group
Short administration distance
• Advantages – worker is usually primary one who receives advantage of this situation – communication channels shorts – messages you get are less confusing or distorted – workers happier – decision making processes run smoother
• Disadvantages – may have less contact with supervisor – may be lack of knowledge of operations in which they’re responsibility – workers need education in how to make good decisions – larger organizations find it difficult coordinating and getting consensus
Ex school of nursing at UFV
Compare and contrast the various types of organizational theories #1
1. Classic • 1900s goal was high production, efficiency and profit • Communication – top to bottom • Very impersonal • Very simple relationships • Key features – centralized control, well defined superior subordinate, rewards accomplishments, promoted on basis of competency • Division of labour on basis of skills • Each worker does 1 task • Rule governed • Organization is very important • Focus is on task • Worker is of little importance
Compare and contrast the various types of organizational theories #2
- Humanistic
• 1930s goal was economic, productivity, profit job satisfaction led to improved production
• Communication was vertical
• Participation of workers
• Wanted to be of equal value
• Higher productivity
• Felt if they involved workers in planning and decision making they got more out of it
• Focus is more on individual than organization or work although organization still remains important
Compare and contrast the various types of organizational theories #3
- Modern
• 1950s strive to meet a common goal, communication was horizontal and vertical
• Organization and worker are seen as a whole
• Continues to evolve
• Open system
• Team concept arose from this
• Focus is on individuals and organizations as well as roles
• Status and context is important
elements of organizational structure
- Complexity
- Size
- Geographical dispersion
- Formalization
- Centralization
Explain the purpose of healthcare delivery models
To organize nursing care for patient care delivery
Compare and contrast the advantages and disadvantages of various nursing care delivery systems
- Total patient care or case method
- Functional method
- Team method
- Primary method
- Nursing case management
What is the focus of organizations?
To assist individuals to work together to achieve a common purpose
what is an organizational structure?
Framework for the working relationships among members of the system
what is structure?
How a group is formed and is the formal relationship within each organization
What is the goal of an organization?
Seek a structure that is efficient and provides maximum cost effectiveness
What is the goal of a structure?
Achieve the mission, vision and philosophy of the organization
mission, philosophy and values
Mission
• Purpose of the organization
• Outlines organizations primary plans or driving forces
Vision
• Provides a conceptual view of what the future of the organization desires to look like
Philosophy
• General imbedded into mission statement
Values
• Largely describe the organizations boundaries while pursuing the vision
organizational designs
• Classified by their characteristics of complexity, formalization and centralization
• How the labour is organized will have a direct bearing on how the mission of the organization is achieved
• Must consider the complexity of an organization and the division of labour
• Clear division of labour
• System of procedures to deal with work situations must exist
o What must be accomplished in a day/shift
characteristics of an organization
- Common goal
- Coordination of effort
- Division of labour
- Established delegation of authority
models of care delivery #1
1. Total patient care/case method • Oldest known model • Nurse patient ratio 1:1 • Predominant model of care in high acuity settings o Advantages Consistent, holistic care Needs met very quickly Subtle changes noted quickly Very useful with complex patients o Disadvantages Expensive Not ideal with nursing shortage
models of care delivery #2
2. Functional method • Each employee has a designated set of tasks, skills and activities o Advantages Efficiency Unskilled workers can be trained to do specific tasks (tasks done very well) Give care to large number of patients Fewer nurses Expectations very clear o Disadvantages Fragmentation of care Nurses have little satisfaction/growth Patients get overlooked Confusion for patients Critical changes may go unnoticed Poor communication lines
models of care delivery #3
- Team method
• Based on the basis that each unit will have 2 or more teams to provide care to a geographic location of patients
• Each team has various educated care providers (RN, LPN, care aid etc)
o Advantages
Improved patient satisfaction
Using each person to the highest of their ability
Less fragmentation of care
Cost effective
Works with multiple levels of health care
o Disadvantages
If team leader has poor communication/leadership skills
Duplication of care
Need time for conferencing
Legal risks if poor communication or patient declines
models of care delivery #4
- Primary method
• One nurse functions as the patients primary caregiver throughout their entire length of stay
• RN plans and delivers all the care
o Advantages
Noted increased quality of care
Nurses further their education and knowledge to provide optimal care of their patients
Increased job satisfaction
Establish relationship with patient and family
Decreases number of unlicensed personnel
Increased knowledge of your patient
o Disadvantages
Lack of experience or education of RN
Shorter stays
Large number of part time RNs
RNs are held accountable even if not physically present for 24 hour responsibility of care
Costly
models of care delivery #5
- Nursing case management
• System in which healthcare services are controlled and monitored
• Identification of a critical pathway for care and treatment
• RNs most often act as a case manager
o Advantages
Patient receives more services and have fewer unmet needs
Cost effective
Better patient monitoring
Decreased complications
Nurse satisfaction
Decreased hospital stays
o Disadvantages
Duplication of services
Turf wars between services (RN and social worker etc)
