Introduction
In the system of life values, the main place is given to the health of both an individual and society as a whole. The leading direction of modern healthcare is to meet the needs of the population for high-quality medical care and optimize the state of health. This involves, in the conditions of a sharp limitation of internal resources, innovative activity of medical and preventive institutions and their departments.
The effective functioning of the healthcare system requires the availability of professional medical personnel, the development of infrastructure and resource provision, and the improvement of the organizational system. Despite the fact that these issues are being resolved on a national scale, each medical and preventive institution has specific goals to improve the quality of medical care. In research, much attention is paid to improving the work of health facilities in large cities. Unfortunately, regional clinics often face even more complex and time-consuming problems. This work examines the advantages and limitations of existing and new organizational systems in order to determine a more beneficial structure for the Chifley District Hospital.
Mission Of the Chifley District Hospital
One of the main goals of the Chifley District Hospital is to improve the quality and accessibility of specialized medical care to patients. Structural and organizational restructuring has become an important area of modernization of the institution.
Being a regional institution, Chifley District Hospital is currently changing its organizational structure, significantly expanding the profile of medical care, and increasing the number of hospital beds more than twice (from 130 to 300). In addition, the structural reorganization of the Chifley District Hospital includes a review of the composition and capacity of the units, and an increase in the efficiency of the use of core resources. The adoption of such a number of organizational decisions is due to the current social situation, namely, the growing need of the population for highly qualified specialized medical care.
Current Organizational Structure
Strengths
The main strengths of the existing system are the centralization of the healthcare system, and its accessibility to all citizens. The Chifley District Hospital provides basic types of specialized medical care. This type of organization is less resource-intensive than the new one, since it involves the use of fewer financial, material, labor and other resources. Thus, the costs of inpatient or outpatient treatment are insignificant due to the lack of a large number of beds (Marquis et al., 2017). Since the hospital does not have a large number of devices for diagnosis and examination, there is no such significant item of expenditure as modernization and repair of equipment.
In addition, due to the small number of structural units, the quality of solutions is improved. With the current organization, the management links correspond to the management functions and the number of management levels is minimized. Thus, a direct connection between the nurse and the doctor is formed, so that all prescriptions are implemented clearly and correctly (Sullivan, 2017). There is close cooperation between departments, and the growth of horizontal links and independence of departments in decision-making is ensured.
Limitations
A significant number of shortcomings of the existing system are primarily due to the insufficient number of beds and medical personnel. The quality and accessibility of medical care to the district population in modern conditions are significantly inferior to the level of medical care to the urban population. The capacity of the hospital, the profile of specialized departments in its composition are too small for the size, density and structure of the Chifley demographic number.
The current capacity of the hospital is not favorable, since the possibilities of providing qualified inpatient care in low-capacity hospitals are very limited. This negatively affects the level of professionalism of medical personnel and, as a result, the quality of inpatient care (Maddern et al., 2006). With the existing structure, it seems time-consuming to provide medical care in inpatient conditions with multimorbid pathology, when selecting therapy in case of detection of chronic diseases, as well as for conducting course treatment for patients of the dispensary group. This implies the need to modernize the model of hospital care, change approaches to the functioning of hospitals. Thus, the quality and availability of qualified medical care for residents are not high enough; the guarantee and timeliness of assistance are declining. For these reasons, the potential of Chifley District Hospital should be used to organize qualified patient care in accordance with their growing needs through the structural reorganization of the institution.
New Organizational Structure
A linear-functional organizational structure is proposed as a new organizational structure. This is a management structure that combines both linear and functional principles of organization between the management elements of the system.
Weaknesses
The main problems of the new organizational structure will be an increase in horizontal and vertical connections between employees. There may be some problems that consist in the implicit expression of these links or their inefficient operation. Consequently, the most important cause of potential difficulties may be inefficient management of the organization, and insufficient development of both horizontal and vertical links in the organizational structure of the medical institution. Thus, the timing of the flow of information on these links may be increased, which will reduce the effectiveness of managerial decision-making both at the level of performers and at the level of management. There is another important organizational problem – the preservation of hierarchical subordination (Westphal, 2005). When the number of divisions increases, there will be a problem with the establishment and strengthening of horizontal and vertical links of subordination of a doctor-a narrow specialist to a specific manager.
However, these weaknesses can be overcome or avoided by using a tool to increase the effectiveness of such interaction through the use of digital technologies. Thus, managers will see the work of all subordinates, and doctors will be in a certain team within the interest of one patient, or in the interests of one technology, observing uniform standards and generally accepted rules of work in the clinic. When the structure and management bodies of a medical organization work like this, all participants in the treatment process will benefit, and the occurrence of weaknesses and limitations will be avoided.
Strengths
The new organizational structure will have a beneficial effect both on the quality of patient care at Chifley District Hospital and on the working conditions of employees. Patients will be able to receive highly specialized, including high-tech, medical care. Due to a larger number of specialists, the organizational structure of the hospital staff will be based on the observance of unity of command. In conditions of a sufficient number of employees, it will be possible to linearly build departments and a clear distribution of management functions between them. Thus, doctors of a wide profile (surgeon, therapist, obstetrician-gynecologist, pediatrician) will not need to perform the duties of doctors of narrow specialties.
There will be no need to redirect the patient to another consulting and diagnostic center, dispensary, hospital, rehabilitation center due to the lack of necessary specialists. A continuity will appear between the links of medical care, which will make it possible to exclude duplication of diagnostic studies (Mickan et al., 2006). This will ensure the complexity in the prevention, diagnosis, treatment and rehabilitation of patients. The internal environment of the medical institution will be used with authority in all areas, including financial, labor, material resources, and organizational culture.
Conclusion
In conclusion, it is important to note that the strategic development of the Chifley District Hospital will be carried out within the framework of the main directions of social policy to improve the quality and accessibility of medical care. Due to this criterion, the new organizational structure is more productive than the old one. As a result of the considered restructuring of the medical and diagnostic complex, the productivity of the treatment process will expand, and also, after the introduction of multi-specialty, medical performance indicators will improve.
The quality of rehabilitation and organizational activities increases significantly after the reorganization of the treatment process system. An important prerequisite for carrying out the planned system of transformations is the emergence of new needs that can no longer be met with the help of the old system. Due to the restructuring, additional methods of examination and rehabilitation care will become available to patients of the Chifley District Hospital, and the effectiveness of therapeutic effects will increase.
The reorganization of the activities of the Chifley District Hospital is carried out on the basis of the consistent introduction of a wide range of new organizational and management technologies. The complex nature of the reorganization of the institution’s activities makes it possible to provide a solution to the accumulated problems of rationalizing the use of resources. As a result, the changes are also contributed to expanding its resource potential in terms of strengthening the material and technical base, personnel development, and ensuring sustainable financing.
References
Maddern, J., Courtney, M., Montgomery, J., & Nash, R. (2006). Strategy and organizational design in health care. In M.G. Harris & Associates (Eds.), Managing health services: Concepts and practices. Sydney: Mosby Elsevier.
Mickan S.M., & Boyce, R. (2006). Organisational change and adaption in health care. In M.G.Harris & Associates(Eds.), Managing health services: Concepts and practices. Sydney: Mosby Elsevier.
Marquis, B.L., & Huston, C.J. (2017). Organizational structure. In Leadership roles and management functions in nursing: Theory and application (pp. 292-305). Philadelphia, PA: Wolters Kluwer Health.
Sullivan, E.J. (2017). Effective leadership and management in nursing (9th ed.) Upper Saddle River, New Jersey: Prentice-Hall.
Westphal, J.A. (2005). Resilient organizations. Matrix model and service line management. Journal of Nursing Administration, 35(9), 414-419.