ORGANIZATIONAL CONCEPTS AND STRUCTURES

Complex

FACTORS AFFECTING ORGANIZATION STRUCTURES

Technological Influences

- Organizational structures are affected by the economic, political, social and technological pressures in society and
follow changes in vertical and horizontal integration, geographical distribution

OLD WAYS
NEW WAYS
Information was in only one place

Trends Affecting Organizational Structures

Information is simultaneously in many places
FROM
Only experts could perform complex tasks
To
Generalists can do expert tasks
Hierarchical management
The organization was centralized or decentralized
Flat organizations with cross-functional terms
The organization is simultaneously centralized and decentralized
Formal channels of communication
Managers made the decisions
Free access to information
Everyone makes decisions
Functional fiefdoms
Field personnel needed offices
Organization without boundaries
Field personnel can work anywhere
Division of labor
Best contact was a personal contact
Empowerment of employees
Best contact is in an effective contact by any of numerous modes
Division and simplification of work
Field personnel had to find out where things were
Enrichment of work through multiple tasks and expanded knowledge
Things tell where they are
Simple

Plans got revised periodically

Explains the organizational culture

Plans get revised instantaneously

Is knowledgeable about the culture

Supports advisory personnel

Leadership and Management Regarding Organizational Structure

Uses advisory personnel

LEADER
MANAGER

ORGANIZATIONAL CHARTS

Evaluates the organizational structure

- An organizational chart is a drawing that shows how the parts of an organization are linked.

Is knowledgeable about the structure

- It depicts the formal organizational relationships, areas of responsibility, persons to whom one is accountable and
channels of communication.

Encourages employees to follow the chain of command

Maintains unity of command

- It is used for outlining administrative control, for policy making and planning to evaluate the strengths and
weakness of the current structures, and for showing relationships with other departments or agencies.

Counsels employees who do not use the chain of command

- It can also be used to orient new personnel or to present the agencys structural design to others.

Clarifies the unity of command

Models responsibility and accountability

Advantages and Disadvantages of Organizational Charts

Establishes a span of control

ADVANTAGES

Helps staff see how their roles fit into the structure

DISADVANTAGES

Provides organizational charts

Contributes to sound organizational structure

Encourages upward communications

Becomes obsolete quickly

Follows the chain of commands

Maps lines of decision making authority

Facilitates the informal group

Shows only formal relationships

Uses the informal organization

Shows formal lines of communications

Does not show informal communications

- Is the formal line of authority and communications

Shows how people fit into the organization

May show how things are supposed to be rather than how they are

Centrality

Helps employees understand their assignments

- Indicates the location of a position an organization where frequent communication occurs.

May help confuse authority and status

- It is determined by organizational distances.

Charts may foster rigidity in relationships and communications.

- Employees with small organizational distance are able to receive more information than those more peripherally
located.

People may be sensitive about their relative status in the organization and may not want their positions revealed.
- Middle managers tend to have a broad view of the organization because of the centrality for receiving upward,
downward and horizontal communications.
VERTICAL CHARTS
HORIZONTAL CHARTS

Unity of Command

CONCENTRIC CHARTS

- Represented by the vertical solid line between positions on an organizational chart.

Depicting chief executive at the top with formal lines of authority down the hierarchy

- It indicates one person has one boss.

Left-to-right
Depicts the chief executive at the left with lower echelons to the right

Authority

It follows normal reading habit, shows relative length of formal lines of authority, helps simplify the lines of
authority and responsibility, reveals problems within the structure

- Is the official power to act

- It is the power to direct work of others

Circular chart
Shows chief executive in the center with successive echelons in concentric and charted.
Person with most relationship is often the leader
Chain of Command
Responsibility

- Is a duty or an assignment
- A person needs the authority necessary to accomplish the assignment

FLAT VERSUS TALL STRUCTURES

FLAT STRUCTURE

Accountability

TALL STRUCTURE

- Is a moral responsibility. A manager may delegate responsibility but always remains accountable.

Is developed along horizontal dimensions according to the number of organizational functions.

Is developed along vertical dimensions by the use of the scalar process to define relationships between levels in an
organization.

LEVELS OF MANAGEMENT
Top Level Managers
- Generally makes decisions with the help of few guidelines or structures, coordinate internal and external
influences and view the organization as a whole.
- They include the chief executive officer, the organizations highest ranking individual, and the top level nurse
manager.

Flat structure shortens the administrative distance between top and bottom levels in the organization, thereby
minimizing distortions through shorter lines of communication.
Communications are direct, simple, fast and clearly apparent to employees.
Messages from managers are given more attention than those from peers and consequently pass through levels
quickly.
Narrow range of management allows staff to evaluate decisions frequently.
Large groups have a greater variety of skills available and are capable of solving a greater variety of problems.

Middle Level Managers

Contributes to high employee morale and help develop capable, self confident staff.
- Conduct day-to-day operations with some involvement with long term planning and policy making.
- Titles vary but includes supervisors, unit manager or head nurse
Lends itself to a democratic approach and general management, which are preferred by many people. This minimal
social stratification is consistent with an egalitarian political and social philosophy.
First Level Managers

Lends themselves to authoritarianism, which is most effective in situations requiring rapid changes and precise
coordination.

- Are concerned with specific units work flow

- They deal with immediate day-to-day operations problems.
DECENTRALIZATION VERSUS CENTRALIZATION
- Titles vary but include case manager, nurse practice coordinator, primary care nurse, team leader or charge nurse.

- Decentralization is the degree to which decision making is diffused throughout the organization.

- Disadvantages

- It is relative, for the degree of decentralization is larger when more important decisions affecting more functions
are made at lower levels with less supervision

- Organizations may not be large enough to merit decentralization, or it may be difficult to divide the organization
into self-contained operating units

- There are several factors to consider when determining optimal degree of decentralization for an organization.

- Top administrators may not desire

- People in top management need a positive attitude toward decentralization and they need competent personnel to
whom they can delegate authority

- An increased awareness of division consciousness and a decrease in company consciousness may develop

- Latter need access to the information necessary for decision making

- Divisions may become individualized and competitive to the extent that they sacrifice the overall objectives for
short-range profitability and work against the best interests of the whole organization

- In general, the larger the organization the greater the number of complex decisions that must be made and that can
overburden top management and delay decision making. Smaller decentralized units reduce the number of
decisions made by each manager and increases the time available to devote to each problem.

- Because of conflicts among division, it may be difficult to obtain a majority vote, and compromises the result

- Some functions lend themselves more readily to decentralization than do others; production, marketing, personnel
and some purchasing may be readily decentralized.

- Functions are likely to be duplicated between divisions and headquarters

- Involves increased costs; it requires more managers and larger staffs

- Division managers may not inform top management of their problems

- Finances, accounting, data processing of statistics, and purchase of capital equipment are likely to remain
centralized.
- The advantages of decentralization seems to outweigh the disadvantages:

- There are problems with control and non-uniform policies

- Even with decentralization, people in top management remain responsible for long-range objectives and goals,
broad policies, selection of key executives and approval of major capital expenditures

- Increases morale and promotes interpersonal relationships.

- Increased motivation provides a feeling of individuality and freedom that in turn encourages creativity and
commits the individual to making the system successful.

Departmentalization

- Fosters informality and democracy in management and brings decision making closer to the action

- Results from span of management, division of work and need for cooperation.

- Fewer people have to exchange information, consequently, communications are swift and effective

- Its primary purpose is to subdivide the organizational structure so that managers can specialize within limited
ranges of activity.

- Helps determine accountability

- Makes weak management visible through semi-independent and often competitive divisions
Clusters
- Releases top management from the burden of daily administration, freeing them for long-range planning, goal
and policy development and systems integration.

- Are two or three clinically similar units that share resources such as staff, equipment, and educational materials

- Fosters collaboration and consultation among nurses, decreases the isolation of decentralization and enhances
professional marketability by expanding the knowledge and skills.

- It naturally follows organizational affiliations, mergers, consolidations and integrations

- Downsizing or right sizing by cutting the number of positions is also restructuring requiring redesign.

ORGANIZATIONAL STRUCTURE
Reengineering
Organizational Redesign, Restructuring and Reengineering
- Examines the process of health care delivery to improve it
- To maintain market position by reducing the cost of health care, jobs are being redesigned, organizations are
being restructures, and systems are being reengineered.

- Although it is collaborative, patient centered and data driven, it usually involves the entire organization and
makes changes affecting the organization and its members.

Redesign
TYPES OF ORGANIZATIONAL STRUCTURES
- Focuses on individual jobs in one setting although it may be occurring in several areas simultaneously or
consecutively.
- The distribution of activities, excess specialization, role overlap, and waste are examined to redesign each job to
appropriate tasks and appropriate qualifications to be efficient and effective.
- It is also intended to facilitate motivation, higher quality work, greater job satisfaction, less absenteeism and
lower turn over

Formal
- Furnishes the formal framework in which the management process takes place
- Provides an effective work system, a network of communications and identity to individuals and the organization
and should consequently foster job satisfaction.
- Formal organizational structure is defined y executive decision determined by planning.

- Unfortunately, downsizing and restructuring efforts such as differentiated practice and shared governance often
lead to resistance, job dissatisfaction and little motivation.

Restructuring and Reengineering deal with the entire organizations structure to improve its functioning and
productivity

- It can be diagrammed to show the relationships among people and their positions.

Informal
- Compromises personal and social relationships that do not appear on the organizational chart. This might include
a group that usually takes breaks together, works together on a particular unity, or takes a class together.

Restructuring

- It is based on personal relationships rather than on respect for positional authority.

- Changes the structure of the organization.

- Helps members meet personal objectives and provides social satisfaction

- It provides social control of behavior. The control can either be external or internal.

- They may feel insecure and fear their associates.

- It has its own channels of communication, which may disseminate information more broadly and rapidly than the
formal communication system. Unfortunately, the grapevine may contain rumors that are not authentic. The best
way to correct an invalid rumor is for managers to provide accurate information.

- Autocratic behavior may become a defense mechanism through the use of power and fear strategies over staff
members and the enforcement of norms through arbitrary or rigid rules.
- Use of reward and punishment to get desired behavior may alienate personnel.
- Self-serving behavior patterns may develop

Bureaucratic Structure
- Certain aloofness can result from the specialization that leads to impersonality
- A hierarchy or bureaucracy is an organizational design to facilitate large-scale administration by coordinating the
work of many personnel.

- Personnel also may develop a ritualistic attachment to routine, develop monotony and alienation, become
aattached to subgoals and show resistance to change.

Dual Management
Line and Staff Structure
- Separates technical and administrative responsibilities.
- Develops when a simple line structure is altered to provide support to line authorities.
- One hierarchy in which technical professionals make technical decisions and control technical matters
- The line functions are command and control.
- Another hierarchy in which management makes decisions about issues such as personnel and budget
- Staff functions are separate from the chain of command, involve specialization and supportive to line authority.

Advantages
- Suited for work requiring large numbers of moderately educated people who perform routine tasks

- Staffs do what the executives are busy to do. It is the function of staff to serve the line organization and to
submerge personal interests to champion the executives long-range objectives.
- Advantages are that the executive can delegate tasks that the executive does not have the skill or time to do to
functional experts.

- Orientation is easy because workers do few procedures in a narrowly circumscribed job description.
- Orders can be transmitted quickly

- Disadvantages are that executives may get the credit for staff recommendations. Staff may increase their
influence by usurping the authority of the executive by making decisions without consulting the executive. The
executive may ignore the staff recommendations.

Disadvantages
Functionalized Line and Staff Structure
- Detrimental to healthy personality patterns by predisposing people to the authoritarian leadership style, increasing
insistence on the right of authority and status and fostering a pathological need for control.

- Staffs have some authority over line executives.

- The staff expert responsible for a specific management function, such as staffing, staff development, or quality
improvement, has authority to command line executives to implement staff plans.

- They have resulted from behavioral research to facilitate job satisfaction and creativity, as well as efficiency.
- They give greater recognition to the informal structure.

- The advantage is that this can increase staff morale.

- Motivation is derived from system needs, task-related factors and peer pressure rather than from supervision.
- Unfortunately, when the line organizations chain of command is broken, conflict, confusion and poor
communications can result.

- Rewards are based on individual and group results rather than subjective evaluations from managers.

Adhocracy Organizational Models

MERGER

- More free form, open, flexible and fluid than other bureaucratic models

- Essentially means that one organization will join its assets with another.

- Boundaries separating internal and external relationships are more easily penetrated.