Organisational Structure And Healthcare Capacity: A Critical Analysis Of Witlam Memorial Hospital Essay.

Organisational Structure and Capacity in Healthcare

Discuss about the Traditional Bureaucratic Management Practices.

According to Mancini (2007), the capacity of a healthcare organisation is a mainly deepened on the capacity of its resources and workforce. According to the organisational theory organisations are basically collection of individuals who are brought together under a particular environment in order to achieve a definite set of pre-determined objectives. The concept of organisation and its capacity is extremely important under the context of healthcare because, the market of healthcare is continuously changing including technological, economic, scientific, social, political and demographic changes. All these changes affect the health and healthcare demands of a particular society or group of population leading to a demand in the increase in the organisational capacity (Spaulding et al., 2017).

The following essay aims to critically analyse the organisational structure of Witlam Memorial Hospital (WMH) under a context of the given case study. The critical analysis of the organisational structure will be done on based on the strengths and limitations of the present functional structure, analysing the importance of the organisational vision, mission, goals and objectives and subsequent linking them to the organisational structure. The essay will also aim to identity a different organisational structure that suit WSH much better under the context of the increasing patient inflow.

Having an ordered organisational structure based on any of the underpinning organisational theory and proper strategy helps an organisation to achieve better patient outcome in the healthcare domain. It also helps the organisation to work effectively over an increased workforce and that too in much co-ordinated manner.

As per the case study, it is evident that WSH organisation follows traditional bureaucratic organisational structure. The Max Weber’s bureaucratic theory is well known in the domain of healthcare. The traditional bureaucratic theory is based on the concept of hierarchical structures along with strict professionals lines (commonly known as professional bureaucracies), rules, regulations, work standards and operational procedures (Daly et al., 2014). Moreover, Daly et al. (2014) further opined that the traditional bureaucratic structure is also based on the ongoing efforts to improve the overall efficiency along with the productivity of the workflow. Proper division of the work design along with a set of rules and regulations to ensure uniform standards in the work culture helps in the maintenance of stability within the organisation (Daly et al., 2014). In context of the advantage of the traditional bureaucratic organisational structure, Manzi and Darcy (2017) is of the opinion that the traditional bureaucratic organisational structure promotes stronger and forward looking yet efficient leader at the helm. These leaders tend to evolve just as rapidly as like that of the associated flatter organisations however with the less associated drama. This lack of drama and strict policies help in the achieving the desired goals within the projected span of time. The traditional bureaucratic organisational structure will help WMH to stringently handle increase flow of the patients under increase bed numbers (250) with limited budget. The concept of top-down hierarchies as promoted by the traditional bureaucratic organisational structure will promote down flow of the communication from the leader (nursing leader) to the subordinates staffs and thereby helping to disseminate the strategies and goals in an ordered manner (Singh, 2013).

Critical Analysis of the Organisational Structure of Witlam Memorial Hospital

However, traditional bureaucratic organisational structure is associated with certain set of limitations. According to Packendorff and Lindgren (2014), this type of organisation structure only make sense for the organisation whose main flow of work does not involve the incorporation of effective brain work. In order words it can be said that the traditional bureaucratic organisational structure is mostly suitable in the type of the organisation where manual labour is the main source productivity. However, in the domain of healthcare organisation, mental labour is more pronounced in comparison to that of the physical labour. It is the duty of the healthcare professionals to work or to take effective decision based on the prevailing scenario or patient demands. Having a strict set of rules and strict sense of the orders and hierarchical pressure hampers the overall concept of patient-centred care plan and thereby decreasing the quality of care (Gittell, Godfrey & Thistlethwaite, 2013).

Other set of advantages and disadvantages associated with the traditional bureaucratic organisational structure are highlighted below

 
(Source: Spaulding et al. 2017)

Organisational vision is to provide proper health experiences that are able to respond according to the changing requirement of the community

The mission stated of the WMH is to provide best possible quality, speciality in the health care via joining into active partnership with the patients their family of carers, the community in large and other associated group of healthcare providers.

The strategic goals of the WMH is to develop a multidisciplinary team that is highly performing and is efficient in procuring specialist services in order to procure high-quality patient centred care which is effective, efficient and at the same time is able to respond to the changing healthcare needs of the population.

The vision, mission and the goals of the organisations are is proper co-ordination with each other. According to Maddern et al. (2006) the vision statement is about how the organisation wants to achieve in the future and is especially designed to motivate staffs. However, the vision statement of WMH though provides future direction lacks significance in the domain of staff motivation. Maddern et al. (2006) is of the opinion that the mission statement is the purpose of the organisation and it deals with the concise description of the why the organisation exists and the purpose behind it. The mission statement of WMH mainly deals with  quality and speicality of the service procured and this agin align with the vission statement of WMH which also deals with quality of the health care as evident from its highlight over the healthcare experiences of the service users. Maddern et al. (2006) is of the opinion that the core values or the goals of the organisation are set in order to generate prioroties and belives of the resources working under the organisations. The goals of the WMH is set according to the vision and the misison statememnt like, the mission and the visison statement mainly promotes the imporvement of the overall quality of the patient care while managing the high patients. For example, the goal of the organisation promotes the concept of the multidisciplinary team. Accoridng to Weaver, Dy and Rosen (2014) creating multidsiciplinary team helps in the effective imporvement of the overall quality of patient care.

The Strengths and Limitations of the Present Bureaucratic Structure of WMH

The organisational structure however, fail to aligns with the overall mission, vission and goals of the organisation. This is because, Singh (2013) is of the opionion that the organisation that obeys traditional bureaucratic organisational structure at times fail to work on quality as they are  mostly focused over the quantity of the workflow.

The best suited organisational structure for WMH will be informal organisational structure. According to Marquis and Huston (2015), bureaucratic organizational or line organizational structure has a clear level of hierarchy showing who reports to whom. However, this structure has certain disadvantages like lack of proper flow of the communication and at the same time, the different layers of bureaucracy also inhibit the upward feedback or it can be said that the communication is dependent on the upper or the middle level manager. So, in order to promote effective communication to make the current resource and the work flow flexible with the present changing internal and external environment, it informal organizational structure will be best suited. Informal organizational structure will promote effective communication among the different spheres of the healthcare professionals and thereby helping to make them flexible with the present mode of change. This is because, Huczynski, Buchanan and Huczynski (2013) is of the opinion that the informal organizational structure often helps to circumvents the strict lines associated with the authority and horizontal mode of communication and thereby helping to get the job done based on the different lines communication. However, informal organizational structure is often associated with lack proper discipline and observance of the proper rules and regulations while executing the workflow. This lead to the generation of trouble in the healthcare sectors as discipline is the main rule behind its success. Thus, proper monitoring by a higher official is mandatory.

Conclusion

Thus from the above discussion, it can be concluded that effective organizational structure is important for the overall organizational success that promotes proper communication between different spheres of the healthcare staffs and thereby helping to active success in terms of quality or quantity. However, proper discipline or reporting is also required to be maintained in order to proceed towards the goals of the organization (WMH) in an ordered manner.

References

Daly, J., Speedy, S.& Jackson, D.  Leading and managing in nursing practice. In J. Daly, M.N. Hill & D. Jackson (Eds.). (2014). Leadership & nursing (2nd ed.).Sydney: Elsevier

Gittell, J. H., Godfrey, M., & Thistlethwaite, J. (2013). Interprofessional collaborative practice and relational coordination: improving healthcare through relationships. https://doi.org/10.3109/13561820.2012.730564

Huczynski, A., Buchanan, D. A., & Huczynski, A. A. (2013). Organizational behaviour (p. 82). London: Pearson. Retrieved from:  https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.473.7000&rep=rep1&type=pdf

Maddern, J., Courtney, M., Montgomery, J., & Nash, R. Strategy and organisational design in health care. In M.G.  Harris & Associates. (2006). Managing health services: Concepts and practices. Sydney: Mosby Elsevier. Retrieved from: https://search.ror.unisa.edu.au/record/UNISA_ALMA11143510110001831

Manzi, T., & Darcy, M. (2017). Organisational research: conflict and power within UK and Australian social housing organisations. In Social constructionism in housing research(pp. 142-158). Routledge. Retrieved from: https://www.taylorfrancis.com/books/e/9781351899635/chapters/10.4324%2F9781315242965-8

Marquis, B.J., & Huston, C. J. (2015). Leadership roles and functions in nursing: Theory and application (8th ed.).Philadelphia: Wolters Kluwer Lippincott Williams and Wilkins. Retrieved from:  https://books.google.co.in/books?hl=en&lr=&id=38mzZLwcOe0C&oi=fnd&pg=PA1&dq=Leadership+roles+and+functions+in+nursing:+Theory+and+application+&ots=aKGD5O8KQQ&sig=PMLZ2SlwMV8hYMaAXrs3Z0dHEr4#v=onepage&q=Leadership%20roles%20and%20functions%20in%20nursing%3A%20Theory%20and%20application&f=false

Packendorff, J., & Lindgren, M. (2014). Projectification and its consequences: Narrow and broad conceptualisations. South African Journal of Economic and Management Sciences, 17(1), 7-21. Retrieved from: https://www.scielo.org.za/scielo.php?pid=S2222-34362014000100003&script=sci_arttext&tlng=pt

Singh, P. (2013). Transforming traditional bureaucratic management practices by employing the Collegial Leadership Model of Emancipation. The International Business & Economics Research Journal (Online), 12(8), 953. Retrieved from: https://www.researchgate.net/profile/Prakash_Singh35/publication/297754773_Transforming_Traditional_Bureaucratic_Management_Practices_By_Employing_The_Collegial_Leadership_Model_Of_Emancipation/links/57e0eca308ae3f2d793ed3f6/Transforming-Traditional-Bureaucratic-Management-Practices-By-Employing-The-Collegial-Leadership-Model-Of-Emancipation.pdf

Spaulding, A., Kash, B. A., Johnson, C. E., & Gamm, L. (2017). Organizational capacity for change in health care: Development and validation of a scale. Health care management review, 42(2), 151-161. oi: 10.1097/HMR.0000000000000096

Weaver, S. J., Dy, S. M., & Rosen, M. A. (2014). Team-training in healthcare: a narrative synthesis of the literature. BMJ Qual Saf, 23(5), 359-372. Retrieved from: https://qualitysafety.bmj.com/content/23/5/359.short