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Advantages and Limitations of the Existing hospital Organizational Structure

Discuss about the Building Organizational Governance in Hospital.

The essay aims at creating an understanding of the situation of the Sydney Community Hospital organizational structure and its relationship with the mission and the goals of the hospitality organizations. The Sydney Community Hospital has been providing acute and emergency services to the local community. With the increasing demand, the hospital has also been found to focus on the needs of changes in its services. This essay aims at analyzing the advantages and limitations of the present organizational structure. Focus will be made in identifying the suitable structure needed to achieve the organizational goals and objectives. Based on the findings, recommendations to overcome the organizational limitation shall be made.

As stated by Van der Voet, (2014), organizational structure is the backbone of an organization upon which the complete organizational activities depend. Bureaucratic organizational structure follows a managerial reporting relationship and a flow of idea and decisions. However, bureaucratic structure follows several layers of management and a single person is not responsible for taking any major decision. If the similar situation is considered for the hospitals, it can be said that this organizational structure has both advantages and limitations. As argued by Al-Amin, Makarem and Rosko, (2016), the organizational head in a bureaucratic form of organization is the one who is well experienced and has profound knowledge about the specific area. In case of a hospital, this particular quality is of utter importance. Undertaking any kind of amateur decision might prove to be fatal for both the organization and its people.

If the changing need of health care and hospital is considered, it has to be said that there has been drastic changes. The urgency of health care has increased. With the availability of medical care insurance along with better technological options, the demand of the consumers has also changed. In addition to this, it has to be understood that the population is also growing and so is their demand. Therefore, sticking to the traditional bureaucratic structure of the hospitals might not be as effective as it used to be. Here lies the limitation of the bureaucratic structure of the hospital. The authority of people is constricted to limited number of people.

Keeping the similar situation into consideration, Askim, Christensen and Lægreid, (2015) has proposed a number of limitations that actually hinders the effectiveness of the work of the practitioners at the hospitals. A horizontal and non-hierarchical structure helps people in the organization to take prompt action. As pointed out by Wallace, (2015), that there remain many individuals like nurses or junior doctors who might not be at the top of the hierarchical structure but they have the profound knowledge and wisdom to handle different crisis situations that might occur at any point of time. In addition to this, a non-bureaucratic structure also helps to increase the morale of the people. This way, people at the hospitals would also be able to meet the dynamic demand of the people in the current situation.

Alternative Organizational Structure Suitable for The Sydney Community Hospital (SCH)

Organizational structure followed by The Sydney Community Hospital (SCH) is functional (bureaucratic) organizational structure where different departments are divided according to their job functions performed. For example nursing services, medical services and corporate services are separated as per their job description and they have relevant employees under each category of services such as the nurse manager managing nursing staff, senior medical staffs managing junior medical staffs and middle managers managing administrative staffs respectively. However, an alternative organizational structure that could be followed by The Sydney Community Hospital (SCH) is a process based organizational structure, which focuses on various different processes within the hospital such as patient treatment fulfillment, research and development, pathological laboratory tests, medicinal facilities, nursing and checks up processes and so on (Al-Ami, 2016).

Unlike a functional organizational structure, the process bases organizational structure focus on different activities performed by personnel in interacting with each other and not just the employee activities being performed. According to Foss (2013), process based organizational structure is very much suitable for improvement of efficiency and speed within a rapidly evolving business environment. Process based organizational structure is very much easy to adapt and hence is recommended to The Sydney Community Hospital (SCH) following functional organizational structure so that overall changing of the structure is not very complicated to shift disturbing existing performance of hospital or hampering ongoing duties of personnel.

The organizational structure of SCH will incorporate five major services that include sustaining and promoting health care, which will comprise of different doctors and nurses having competency and experience in their relevant field such as cardiologists, psychiatrists, pediatrician, ophthalmologists, optometrists, nephrologists, general physician, ENT specialists, dermatologists, urologists and gynecologists (Millar, 2014). These personnel ensure patients coming to the healthcare unit get an effective treatment and gets well. Detection of health issues is another process, which will be controlled by different nursing and diagnostic personnel by SCH to perform various laboratory tests on patients like MRI, X-Ray, USG, ECG, blood test, blood pressure checking, urine test, diabetes test and so on (Zingg, 2015). Operational processes will also be present that includes operation theatres and other surgical services by range of general surgeon and professional dental surgeon to perform complicated surgical operations on patients. According to Mosadeghrad (2014), treatment of disease will be done through process of proper medication units that will ensure range of efficient medicines is available at the healthcare unit all time. Finally patient relation support will make sure that regular arrangement of checkups, appointments, financial support for treatment, old age support and other services are provided to patients efficiently.

Key Line of Authority and Responsibilities for Achieving overall SCH Goals

A process based organizational structure will also help SCH in providing positive health experience towards community (Murray, 2014). With range of various surgeons and medical specialists, SCH will also provide specialist, high quality care in partnership with patients, other healthcare providers and the community.

The key line of authority for the existing organizational structure flows through the CEO to the subordinates. The three subordinates exiting are the director of nursing services, director of medical services and director of corporate services. The director of nursing services manages nurse manager and nurse manager manages the nursing staffs. Director of medical services manages subsequently senior medical staff and senior medical staffs manage the junior medical staffs. Similarly, middle managers who are managed by director of corporate services manage administrative staffs. Current functional organizational structure has a major problem of communication within inter services (Wallace, 2015). Hence, if a nursing staff requires a helps regarding issues for patient appointment, nurse manager needs to be informed following an intimidation to director of nursing services (Sorensen, 2013). Finally, when the notice reaches CEO, it will be forwarded to director of corporate services which will then be forwarded to middle managers and finally to administrative staffs. Therefore, it can be seen that entire communication system is very much complicated that gives rise to delay of tasks and other complexities like arrangement of permission from CEO. Moreover any kind of problems or issues regarding inter services are not sought until CEO is informed regarding the issues. Due to lack of inter service link, proper coordination of services also lacks.

However, following a process based organizational structure will ensure that proper communication is maintained among different services. If communication barrier arises among different services, handing of work will be delayed and create an issue. If the process based structure is followed accordingly, efficiency and speed of the processes is rapidly changed. Moreover, the proposed system is very easy to adopt and causes less confusion regarding sense of job description and authority. A process based organizational objectives ensures improved performance of organization in achievement of mission, vision and value to the core.

Van Dijk-de Vries (2017) commented that following a process-based organizational structure provides an opportunity to SCH in defining a clear guideline of improvement in processes and performance over time. Full set of activities such as customer satisfaction, quality of treatment, quality of medications will be focused as well as financial results that include SCH profits, budgets, cost and revenues. According to Van Riet Paap (2014), wrong decisions will be avoided reducing time, cost and resources of the hospital. Any potential hazard will be anticipated such as possible wrong treatment or improper medication will be identified easily due to availability of process. For example if the administrative staff receives a complaint from a patient regarding improper medication or allergic reaction to certain kind of medicine, it will be soon transferred to medical staffs, doctors and specialists and a solution will be provided to the patient immediately.

It can be concluded that adopting a process based organization management will help in protecting intellectual capacity of SCH. Monitoring development of various nursing processes through analysis of risks and weaknesses will be efficiently done. Continuous improvement within SCH will also be fostered fulfilling patient requirement and satisfaction. Patient services will also be  improved along with process evaluation of results that is anticipated to be obtained by SCH. A process based organizational structure incorporates integration of output as well as input to the healthcare unit controlling doctors, technical personnel, nurses, service providers and other financial resources to a holistic point of view. Moreover, SCH will also become competent in improving its information technology and incorporate advanced IT framework within its healthcare facility. However, it should be kept in mind to mitigate any barrier of communication between services so that services and proper medication to patients are not delayed.

Reference List

Al-Amin, M., Makarem, S. C., & Rosko, M. (2016). Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings. Health care management review, 41(4), 296-305.

Askim, J., Christensen, T., & Lægreid, P. (2015). Accountability and performance management: The Norwegian hospital, welfare, and immigration administration. International Journal of Public Administration, 38(13-14), 971-982.

Foss, L., Woll, K., & Moilanen, M. (2013). Creativity and implementations of new ideas: do organisational structure, work environment and gender matter?. International Journal of Gender and Entrepreneurship, 5(3), 298-322.

Millar, J. A., & Millar, R. C. (2014). Potential cost to Western Australia of proposed patient co-payments according to healthcare organisational structure: a preliminary analysis. The Australasian medical journal, 7(8), 357-359.

Mosadeghrad, A. M. (2014). Factors influencing healthcare service quality. Sage

Murray, P. A. (2014). Organisational structure and strategic control. Sage

Sorensen, L. J., & Stanton, N. A. (2013). Y is best: How Distributed Situational Awareness is mediated by organisational structure and correlated with task success. Safety science, 56(2), 72-79.

Van der Voet, J. (2014). The effectiveness and specificity of change management in a public organization: Transformational leadership and a bureaucratic organizational structure. European Management Journal, 32(3), 373-382.

Van Dijk-de Vries, A., van Dongen, J. J. J., & van Bokhoven, M. A. (2017). Sustainable interprofessional teamwork needs a team-friendly healthcare system: Experiences from a collaborative Dutch programme. Journal of interprofessional care, 31(2), 167-169.

Van Riet Paap, J., Vernooij-Dassen, M., Dröes, R. M., Radbruch, L., Vissers, K., & Engels, Y. (2014). Consensus on quality indicators to assess the organisation of palliative cancer and dementia care applicable across national healthcare systems and selected by international experts. Bmc health services research, 14(1), 396-398.

Wallace, S. M. (2015). The legitimization of bureaucratic personality: an exegesis of weberian theory.

Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., ... & Pittet, D. (2015). Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. The Lancet Infectious Diseases, 15(2), 212-224.

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