Every health care facility has an organizational structure that allows efficient management of departments and staff. Its type is usually based on the size of a hospital. Researchers found the correlation between the organizational design and performance of a hospital-based on the quality of care, efficiency, financial outcomes, patient satisfaction, and human resources (Crêteur & Pochet, n.d.). The commonly practiced type of structure is a bureaucratic organizational structure, also known as line structure, which implies a defined hierarchy of authority, strict rules, rights, and responsibilities for each unit.
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In my hospital, the combination of flat and line organizational design can be observed: all nurses have defined responsibilities, which result in high-quality nursing care and healthy interpersonal relationships. Furthermore, less hierarchical layers in decision- making and decentralization allows responding to emergency situations faster and taking effective preventive measures.
This structure might be monotonous, can create a tense environment between employees as well as create difficulties in adjusting to changing work situations; however, it was proven to be sufficiently effective (Marquis & Huston, 2015). Being a float pool nurse, I get to work with different people; due to the shared responsibilities, the working process is simplified as well as expectations from my colleagues.
The decision-making process in my hospital is decentralized. Managers eagerly involve staff in decision making. The committee performs assigned tasks and monitors the activities carried out by task forces.
The taskforce, in their turn, are assigned specific tasks with a narrowed focus under the supervision of the committee. They report to committees, and committees report to councils. Council serves as a coordinator of all activities. Despite some features of a bureaucratic structure, both formal and informal leadership is present in my hospital. Council and committee are already appointed to supervise activities to meet the goals and objectives of a hospital, but the staff is also actively engaged in decision making.
The level of patient satisfaction can significantly influence the rating of a hospital. Since nurses directly contact with patients, their duty is to advocate for patients’ interests. Therefore, internal stakeholders represented by nurses and patients can substantially influence the decision-making process. Studies report that positive leadership styles directly influenced patient outcomes across a broad range of clinical settings (Wong, Cummings & Ducharme, 2013).
I observed a good example of informal leadership in my workplace: a nurse suggested practical ideas to prevent falls in the hospital, and due to her competence and leadership skills, the management decided to implement her ideas. Usually, informal leaders gain respect through their commitment; they are recognized by the organization for their expertise and, without any legal power, can motivate others (Krueger, n.d.). Informal leaders significantly contribute to the overall performance of a hospital as well as the quality of health care through establishing trustful relationships with patients and their knowledge.
Communication of informal organization of the hospital is also active; it appears to encourage informal leadership and improve cooperation between staff members in my unit. I believe that formal and informal organizational structures can successfully coexist, and in fact, they seem to complement each other towards providing high-quality health care.
Thus, the combination of line and flat structural organization in my hospital seems to have positive outcomes by encouraging staff engagement in decision-making processes and informal leadership.
Crêteur, M., & Pochet, Y. (n.d.). Organizational design and hospital performance. Web.
Krueger, D. (n.d.). Informal leaders and cultural change. Web.
Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Wong C. A., Cummings G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of Nursing Management, 21(5), 709-724.