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Associations Between Organizational Culture

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Discuss About The Associations Between Organizational Culture?




Organizational structure refers to the design of the activities such as task allocation, coordination and supervision. The structure defines the ways in which work roles and responsibilities can be coordinated and controlled. Every organizational intends to grow and deliver maximum profitability. The operations and activities of a healthcare organization is critical as it affects the delivery of healthcare services (Wagner et al., 2014).

A healthcare organization comprises of various departments such as maternity, nutrition, occupational therapy, child care and units such as urgent care centre, surgical units, ambulance units and various others. The number of units and departments varies for every healthcare organization. There is a need for proper communication for the success of healthcare unit. The organizational structure needs to be designed in a manner that is easy to coordinate and lines of communication can build the structure. With effective communication and coordination comes better health services delivery (Slade et al., 2015).

Without a proper and formal organizational structure, the employees of the organization such as doctors, nurses, cleaners and other staffs would not know whom to report officially. The roles and responsibilities shall become unclear if the organizational structure is inappropriate. With a proper organizational structure in healthcare, the employees such as doctors and nurses can turn for direction and help as and when needed. Therefore, an appropriate organizational structure helps in consistent communication which is critical in a healthcare setting. Healthcare organizations have primary safety goals for its patients as well as other stakeholders. Formal structure in organizations can induce and affect behaviour of different processes. For example, the surgical teams in the healthcare can use invasive techniques depending on their leadership and management commitment (Wagner et al., 2014).

It is usually observed that the healthcare organizations follow vertical organizational structure with multiple layers of management in lower to higher authority roles. This structure ensures that the activities in the healthcare setting shall not cause any trouble. Usually, the board of directors are responsible to carry out decisions in the hospital. The healthcare organizations have chief nursing officers, chief financial officers and others who form a part of central core management. Within a department, there are people who look after patient care. The staff members and supervising psychology address their duties and give the best care when something goes wrong with the patient. Therefore, a well-designed organizational structure fits the organizational needs. Every healthcare unit has a mix of talented employees who needs to be controlled by the executives. Therefore, if the organizational structure is poorly designed, critical deadlines shall not be met. Decision making and meeting deadlines is crucial in the healthcare industry as it may cost the lives of patient (De Bono, Heling & Borg, 2014).

Therefore, the healthcare organizations must have an appropriate structure where they are accountable to their seniors. The nurses must be allowed to take decisions as specified by their superior doctors as any negligence can directly impact the health and wellbeing of patient.


Discuss how power can influence decision making in healthcare

Power has been defined as having control, dominance or influence over an individual or group of people. Power also includes the ability to mobilize resources, get things done and conducting practices to empower patients. Power can influence decision making in the healthcare setting for doctors, nurses, cleaners and other staffs (Kilpatrick, 2013).

According to Aarthun and Akerjordet (2014), power influences decision making as political and technical uncertainty is reduced. There are situations when power influences decision making, especially in bureaucratic organizations. The nurses need the power to influence physicians, patients and other healthcare professionals. The nurses who are powerless may be ineffective. Power shall help the nurses and other staffs feel empowered and increase their job satisfaction level. High levels of autonomy and decision making power increases nurses identification. In a healthcare setting, the partnership between nurses and doctors can be difficult due to the role of power. A clinical decision process includes clinical diagnosis as well as assessment. There is a need for proper communication for the success of healthcare unit. Good communication between the patients and nurses helps in better understanding. It may give control to the client of decision making. However, the health practitioner may limit the choices that can be made by the patients. There have been situations where nurses are tried to understand by the doctors for building a collegial relationship. There has been power imbalance between patients and nurses. The research studies have found that people in high position powers think differently. If an individual is perceived by others to have influence, he holds power (Quinlan & Robertson, 2013).

Peer pressure is also a form of power. Power in a small business is present upward, downward and horizontally. It is argued that the nurses may not be allowed to make decisions when it may cost the life of a patient. They are expected to make a combined clinical decision by reporting to their doctor. Both medical and nursing staff identifies conflict during patient management discussions. However, it is predominantly nurses who seek to redress this conflict area through developing specific behaviours for this clinical forum. Also, the power of decision making depends on the operational autonomy and work environment. The nurses have the power to make decisions that have to be rapid. The nurses must be allowed to take decisions as specified by their superior doctors as any negligence can directly impact the health and wellbeing of patient. They can make decisions related to information seeking with novice rather than proficient performance. The strategies available for clinical decision makers can be altered on the basis of information (Joseph-Williams, Elwyn & Edwards, 2014).

Conclusively, power plays a significant role in the decision making in a healthcare setting. The doctors, physicians and nurses have different powers in a healthcare setting based on their hierarchical position, level of expertise and knowledge. The nurses have the power to make decisions that have to be rapid. They do not have the authority to make decisions without the consent of physicians and doctors.



Aarthun, A., & Akerjordet, K. (2014). Parent participation in decision?making in health?care services for children: an integrative review. Journal of Nursing Management, 22(2), 177-191.

De Bono, S., Heling, G., & Borg, M. A. (2014). Organizational culture and its implications for infection prevention and control in healthcare institutions. Journal of Hospital Infection, 86(1), 1-6.

Joseph-Williams, N., Elwyn, G., & Edwards, A. (2014). Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient education and counseling, 94(3), 291-309.

Kilpatrick, K. (2013). Understanding acute care nurse practitioner communication and decision?making in healthcare teams. Journal of clinical nursing, 22(1-2), 168-179.

Quinlan, E., & Robertson, S. (2013). The communicative power of nurse practitioners in multidisciplinary primary healthcare teams. Journal of the American Association of Nurse Practitioners, 25(2), 91-102.

Slade, D., Manidis, M., McGregor, J., Scheeres, H., Chandler, E., Stein-Parbury, J., ... & Matthiessen, C. M. (2015). Communicating in hospital emergency departments. Springer.

Wagner, C., Mannion, R., Hammer, A., Groene, O., Arah, O. A., Dersarkissian, M., ... & DUQuE Project Consortium. (2014). The associations between organizational culture, organizational structure and quality management in European hospitals. International Journal for Quality in Health Care, 26(suppl_1), 74-80.


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