Organizational Structure and Culture Essay

Authority structure within organizations is important for the oversight of delegated processes and expected outcomes. Without structure, chaos would impede support, communications, and vision development. Organizational designs vary according to the need of the organization to operate efficiently, to achieve goals, and to support the associates within the organization. The organizational structure style design helps lead the organization in successful endeavors (Sullivan & Decker, 2009). Organizational History The history of an organization contributes to the design of the formal organizational structure.  The medical center has a tumultuous history. A new modern building was constructed in 2000 to replace an older structure. The local physicians had no input into the decision or design of the new facility. The organizational structure during that time was a strict parallel design. The physicians reported to the chief medical officer and the Board of Trustees. The physicians jointly decided not to support the new local hospital; the organization began to collapse. The medical center eventually fell into bankruptcy because of the lack of physician support, poor financial management, and unscrupulous use of organizational monies. The court system retained a reconstruction organization in an attempt to rebuild the local hospital. During the time of bankruptcy the parallel organizational structure remained in place, but with less authority of the medical governance branch. The main focus of the organizational structure was financial survival of the organization. An immediate change was needed for the improvement of the dangerously low morale of the health care associates The once country owned, bankrupted not-for-profit-hospital was bought and sold twice before stabilization began to be a possibility. A corporation purchased the hospital and changed it to a for-profit organization. There was very little resistance to the change because the organization had been surviving in chaos. According to Kurt Lewin’s three stage theory of change, the first phase, the unfreezing phase, is an important phase of change. Change is getting ready to happen during this phase. The health care associates of the medical center had been getting ready for change for a few years. The unfreezing phase requires the development of motivation. Motivation was the chance to prosper in a successful business venture while delivering quality care to the community (â€Å"Kurt Lewin,† 2012). Generational Culture The generational culture of the organization had a positive effect on the change. There was a common goal developed, the success of the organization. The generational similarities outnumber the generational differences. According Anick (2008), â€Å"The top reason for happiness in the workplace is the sense of feeling valued† (Table 2. Elements on which members of each generation are mostly similar). The traditional, baby boomers, generation X, and generation Y became involved in the decision making as the new organization structure formed. They shared ideas and offered suggestions for patient care improvement. Informal leaders began to emerge. During the refreezing phase, the stabilization became the norm. The differences in the generational culture became more apparent. More processes, greater accountability, and new required use of technology caused a feeling of less worth for the older generation of health care providers. The younger nurses seemed to adapt more quickly to new systems and techniques. Older nurses began to believe they were less important to the process. The informal leader roles changed. A new information system was installed and education was initiated. This led to more attention on the differences of the generational cultures. Much of the required education was completed on the computer. E-mail is essential for communication within the organization. Some of the traditional generation began to feel left behind. At the end of the first year, many of the health care providers who had survived the previous chaos succumbed to the new advancements and left the organization. Current Organizational Design The current organizational structure of the medical center is a matrix design. The upper administration consists of a chief nursing officer, chief financial officer, and an assistant administrator. This group reports directly to the chief executive officer. The chief executive officer reports to the Board of Trustees. The medical center consists of two distinct campuses, four on-site clinics, and one clinic located off campus. The upper administration is responsible for the organization. The matrix esign is complex and requires good interpersonal skills for dual managers. Each nursing unit has a nurse manager. The nurse managers report to the chief nursing officer regarding any patient care issues. The nurse managers of the behavioral health campus also report to the behavioral health program director for organizational issues. The physicians are under the organizational umbrella for operational regulations but report to the chief medical officer regarding medical patient care. The resource manager has a dual reporting line to the chief nursing officer and the chief financial officer. The matrix requires frequent communication between the dual authorities. Non-management views the frequent meetings as meetings about meetings (Sullivan & Decker, 2009) Formal lines of reporting are evident within the organization. The nurse managers report to the chief nursing officer. Managers of departments involving financial business of the hospital report to the chief financial officer. Ancillary and support services report to the assistant administrator. The compliance officer, the pharmacy director and the behavioral health program director report directly to the chief executive officer. The formal lines of reporting are used for recognition of associates, disciplinary offenses, and arbitration of challenges between departments. Patient-Centered Care Environment The organization is creating an environment for client-centered care by the development of a nursing leadership council consisting of direct care providers. The council membership includes seven registered nurses from nursing units with day and night shift representation. The nursing council interviews associates and patients, observes processes, and reports findings to the council. Changes in nursing processes are approved through the nursing council with final approval by the chief nursing officer. The council members were selected using predetermined criteria. The informal leaders of individual departments were chosen for their job performances and their proven leadership skills. The shared governance gives ownership of patient care to the frontline caregivers (Hess, 2004). Organizational Communication Various communication methods are used within the organization. Formal, time sensitive communications are delivered face-to-face or by technology. E-mail and web conferencing are the most frequent used methods for upper administration. Both methods allow quick responses between the communicators. Upper-level management processes the information and decides the best delivery method to the next lower-level management, depending on the subject matter and the expected time frames. Middle management associates attend leadership meetings every two weeks. Management communicates organizational status through these meetings. Plans for future projects are discussed during the leadership meetings. Middle management has e-mail accounts and receives electronic communications on changes. Middle management holds departmental meetings at least monthly to distribute information to the direct care providers. Upper-level management holds open meetings for the direct care providers each quarter. The meetings focus on current organizational trends and plans. Direct care providers ask questions and make suggestions for improvement during the open meetings. Communication boards are placed in strategic areas through the work areas. Information is placed on the communication boards and updated weekly. Questions frequently come from the information from the boards. Conclusion The organizational structure can be descriptive of the culture of the organization. A ridged authoritarian organizational structure defines an organization that does not allow the frontline workers to participate in decisions that affect the organization. The matrix organizational design requires open communication between the leaders of the organization. Added shared governance from the frontline creates more awareness is put on the quality and delivery of the product. Organizational structures vary and are representative of the leadership within.