System and Structure Analysis

Question Description

Healthcare organizations have identified objectives on the services they provide which includes the providers and community that they will be serving (Hickey & Brosnan, 2017). As nursing leaders, it is essential to understand both the formal and informal structures within an organization. Formal structures are easily retrievable and describe the hierarchy of positions and chain of command in an organization (Laureate, 2013f). On the other hand, informal structure refers to the power, culture, and politics within an organization, which is harder to identify (Laureate, 2013f). The purpose of this discussion is to describe an analysis of the systems and structures of ones’ healthcare organization, explain insights gained by comparing two frameworks, and how each are used to assess an organization, identify a need for improvement, and enhance the performance of an organization.

System and Structure Analysis

The term structure refers to the resources allocated to provide services to the patient (Hickey & Brosnan, 2017). The Healthcare system this writer is employed is a 435-bed acute care community hospital. The hospital was built in 1940, embedded within a residential neighborhood. The organization is a not-for-profit organization, which means reinvestment of all profits, go toward resources to improve patient care and serving the community (Hickey & Brosnan, 2017). This healthcare organization has an extremely robust philanthropic fundraising program, which also involves an employee donation campaign, free on-site valet parking for the community and employees, retail pharmacies, multiple professional buildings, and an eatery and gift shop which is run solely by community volunteers and the Women’s Auxiliary. A Board of Trustees govern the hospital.

The Board of Trustees is composed of physicians, hospital executives, lawyers and individuals of power and status within the community. They are responsible for the organizations performance and have authority over finances provided to the organization (Hickey & Brosnan, 2017). The mission, vision and values of the organization is to achieve service excellence, and provide the safest, high-quality healthcare to the community which it serves, and vows to work collaboratively with the community and staff to ensure that innovation, technology and best practice is always utilized (The Valley Hospital, 2019). The formal structure of the organization is hierarchical. According to Hickey & Brosnan (2017), hierarchical organization structures have many layers, similar to a pyramid, where communication flows from the top down or from the bottom up and each layer is subordinate except for the top tier. Although the structure of the organization is hierarchical, the leadership style and culture of the organization more bureaucratic where decision-making is delegated and shared amongst leaders and staff at various layers throughout the organization (Hickey & Brosnan, 2017).

The culture or informal structure of the organization is strong and positive toward the community, its staff and safety. The healthcare system has embarked on a high-reliability journey and is fully committed to transparency, accountability and safety. As a result, the work environment has improved, however, is still affected by staff turnover and retention. Overall, the healthcare system has a strong reputation in the community, through social media, as well as Leapfrog and Healthgrades. The hospital has been Magnet designated since 2009, which has provided a strong environment for nurses to thrive and be a vital element of research, innovation, evidenced-based practices and collaboration on ways to enhance and improve patient care delivery.

Frameworks & Improvement Opportunities

In the article by Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013), the authors discuss the framework of a patient-centered perspective to healthcare. Within this writers’ healthcare organization, this framework was applied to developing care standards for the LGBTQ community. Throughout the healthcare system, patient-family centered care advisors are utilized. Some are employed and others are volunteer. From developing stroke pathways in the Emergency department to creating scripts for discharge follow up nurses; our patients are members of many of our hospital-based committees. This framework has allowed the healthcare system to understand the essence to best serve each patient and execute service excellence. Another framework is the concept of good to great. The good to great method is taking a complex system and streamlining the consistent drive to adhere to an organizations overall mission (Gellar, 2006).

Each pillar of the good to great concept is already reflected throughout this writers’ healthcare system as it is striving for zero harm, 100% reliability, and a strong culture of safety and transparency. However, an area of opportunity to improve is utilizing employee talents. As a Magnet designated organization, an overwhelming number of nurses are bachelor, masters, and doctorate level prepared. The organization does not always utilize the staff as internal experts. An example is hiring a company to lecture on evidenced-based practice when the hospital has full-time PhD educated nurses fully capable of doing this. The same goes for Advanced Practice Nurses (APN). The hospital does not adequately utilize APN’s for patient care, rather they take on an administrative role with quality initiatives such as Medication Reconciliation, or are database administrators. This does not correlate with the organizations overall mission, vision and values to grow and utilize staff talents to build to produce high quality, safe care.

Summary

As leaders in nursing, it is imperative to be able to identify and understand ones’ organizational structure. The formal structure is important as it reflects the formal positions within an organization as well as the lines of communication. The informal structure refers to the culture of an organization and may be more difficult to identify. Being in tuned to ones’ surroundings and observing how communication flows and positions held, can yield great insight into informal structures. By having an understanding of a healthcare organizations structure, leaders can be more effective which provides the best opportunity to achieving shared goals and success.

References

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.

Laureate Education (Producer). (2013f). Organizational structures. Retrieved from https://class.waldenu.edu

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York, NY: Springer Publishing Company.

The Valley Hospital (2019). About us. Retrieved from https://www.valleyhealth.com/valley-hospital

Geller, E. S. (2006). From Good to Great in Safety: What does it take to be world class? Professional Safety51(6), 35–40Healthcare organizations have identified objectives on the services they provide which includes the providers and community that they will be serving (Hickey & Brosnan, 2017). As nursing leaders, it is essential to understand both the formal and informal structures within an organization. Formal structures are easily retrievable and describe the hierarchy of positions and chain of command in an organization (Laureate, 2013f). On the other hand, informal structure refers to the power, culture, and politics within an organization, which is harder to identify (Laureate, 2013f). The purpose of this discussion is to describe an analysis of the systems and structures of ones’ healthcare organization, explain insights gained by comparing two frameworks, and how each are used to assess an organization, identify a need for improvement, and enhance the performance of an organization.

System and Structure Analysis

The term structure refers to the resources allocated to provide services to the patient (Hickey & Brosnan, 2017). The Healthcare system this writer is employed is a 435-bed acute care community hospital. The hospital was built in 1940, embedded within a residential neighborhood. The organization is a not-for-profit organization, which means reinvestment of all profits, go toward resources to improve patient care and serving the community (Hickey & Brosnan, 2017). This healthcare organization has an extremely robust philanthropic fundraising program, which also involves an employee donation campaign, free on-site valet parking for the community and employees, retail pharmacies, multiple professional buildings, and an eatery and gift shop which is run solely by community volunteers and the Women’s Auxiliary. A Board of Trustees govern the hospital.

The Board of Trustees is composed of physicians, hospital executives, lawyers and individuals of power and status within the community. They are responsible for the organizations performance and have authority over finances provided to the organization (Hickey & Brosnan, 2017). The mission, vision and values of the organization is to achieve service excellence, and provide the safest, high-quality healthcare to the community which it serves, and vows to work collaboratively with the community and staff to ensure that innovation, technology and best practice is always utilized (The Valley Hospital, 2019). The formal structure of the organization is hierarchical. According to Hickey & Brosnan (2017), hierarchical organization structures have many layers, similar to a pyramid, where communication flows from the top down or from the bottom up and each layer is subordinate except for the top tier. Although the structure of the organization is hierarchical, the leadership style and culture of the organization more bureaucratic where decision-making is delegated and shared amongst leaders and staff at various layers throughout the organization (Hickey & Brosnan, 2017).

The culture or informal structure of the organization is strong and positive toward the community, its staff and safety. The healthcare system has embarked on a high-reliability journey and is fully committed to transparency, accountability and safety. As a result, the work environment has improved, however, is still affected by staff turnover and retention. Overall, the healthcare system has a strong reputation in the community, through social media, as well as Leapfrog and Healthgrades. The hospital has been Magnet designated since 2009, which has provided a strong environment for nurses to thrive and be a vital element of research, innovation, evidenced-based practices and collaboration on ways to enhance and improve patient care delivery.

Frameworks & Improvement Opportunities

In the article by Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013), the authors discuss the framework of a patient-centered perspective to healthcare. Within this writers’ healthcare organization, this framework was applied to developing care standards for the LGBTQ community. Throughout the healthcare system, patient-family centered care advisors are utilized. Some are employed and others are volunteer. From developing stroke pathways in the Emergency department to creating scripts for discharge follow up nurses; our patients are members of many of our hospital-based committees. This framework has allowed the healthcare system to understand the essence to best serve each patient and execute service excellence. Another framework is the concept of good to great. The good to great method is taking a complex system and streamlining the consistent drive to adhere to an organizations overall mission (Gellar, 2006).

Each pillar of the good to great concept is already reflected throughout this writers’ healthcare system as it is striving for zero harm, 100% reliability, and a strong culture of safety and transparency. However, an area of opportunity to improve is utilizing employee talents. As a Magnet designated organization, an overwhelming number of nurses are bachelor, masters, and doctorate level prepared. The organization does not always utilize the staff as internal experts. An example is hiring a company to lecture on evidenced-based practice when the hospital has full-time PhD educated nurses fully capable of doing this. The same goes for Advanced Practice Nurses (APN). The hospital does not adequately utilize APN’s for patient care, rather they take on an administrative role with quality initiatives such as Medication Reconciliation, or are database administrators. This does not correlate with the organizations overall mission, vision and values to grow and utilize staff talents to build to produce high quality, safe care.

Summary

As leaders in nursing, it is imperative to be able to identify and understand ones’ organizational structure. The formal structure is important as it reflects the formal positions within an organization as well as the lines of communication. The informal structure refers to the culture of an organization and may be more difficult to identify. Being in tuned to ones’ surroundings and observing how communication flows and positions held, can yield great insight into informal structures. By having an understanding of a healthcare organizations structure, leaders can be more effective which provides the best opportunity to achieving shared goals and success.

References

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.

Laureate Education (Producer). (2013f). Organizational structures. Retrieved from https://class.waldenu.edu

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York, NY: Springer Publishing Company.

The Valley Hospital (2019). About us. Retrieved from https://www.valleyhealth.com/valley-hospital

Geller, E. S. (2006). From Good to Great in Safety: What does it take to be world class? Professional Safety51(6), 35–40