Organizational Structure

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Organizational StructuresA Report By Charmaine D. Dela Cruz

ADVANTAGE SMaps lines of decision-

L IM IT A T IO N SShows only formal relationships Does not indicate degree of authority May show things as they are supposed to be or used to be rather than as they are Possibility exists of confusing authority with status

making authority Helps people understand their assignments and coworkers Reveals to managers and new personnel how they fit into the organization Contributes to sound organizational structure Shows formal lines of

Organizational Structures Bureaucratic/Line Structure Line and Staff Structure Functionalized Line and Staff Structure Service Line Organization Flat Organizational Design Adhocracy Organizational Models

Bureaucratic/Line StructureThis is the kind of structure that has a very

specific line of command. The approvals and orders in this kind of structure come from top to bottom in a line. Suitable for smaller organizations like small accounting firms and law offices. Allows for easy decision making, and also very informal in nature. Have fewer departments, which makes it decentralized.

Line and Staff StructureAppropriate for small companies

Helps to identify a set of guidelines for the

people directly involved in completing the organization's work.

This type of structure combines the flow of

information from the line structure with the staff departments that service, advise, and support them

Functionalized Line and Staff Structure Classifies people according to the function they

perform in their professional life or according to the functions performed by them in the organization.

Functionalized Line and Staff Structure The organization chart for a functional based

organization consists of Vice President, Sales department, Customer Service Department, Engineering or production department, Accounting department and Administrative department.

Service Line OrganizationAlso called care-centered organizations

Used in large institutions to address endemic

shortcomings of traditional large bureaucratic organizations.

The goals is set by the large organizations but

the service decides on the process to be used to achieve goals.

Flat Organizational DesignsIs an effort to remove hierarchical layers by

flattening chain of command decentralizing the organization. Many managers resist


Flattened Organizational Structure

ADHOC DESIGNA modification of bureaucratic structure Used on a temporary basis to facilitate

completion of a project within a formal line of organization. Uses a project team or task approach, usually disbanded after project is completed.

Matrix Organizational StructureDesigned to focus on both product and

function Has a formal vertical and horizontal chain of command Less formal rules and fewer levels of hierarchy May CONFUSE and FRUSTRATE workers because of its dual hierarchical design

PRESIDENT Functiona Manager l

Vice President Nursing Services Vice PresidentVice President Human Resou Finance Product Manager

President Pediatric Services Nursing Pediatrics Manager of

ident Maternal and Womenof Services Women Services Manager s Nursing

e President Oncology Services Manager of NursingOncology Services

Matrix Organizational Structure

PROJECT MANAGEMENTIs the discipline of planning, organizing, securing and managing resources to bring about the successful completion of specific engineering project goals and objectives

COLLEGIAL MANAGEMENTAlso referred as European-style management Restrictrics monocractic authority by

maintaining a balanced division of power among top management groups The directors represent functional areas It is the board that make policies and decisions

Shared Governance Most innovative and idealistic or organizational

structures Alternative structure




CHIEF NURSE ADMINISTRATORClinical Nursing Practice Administrative Services

Nurse Educator ed Nurse Organization Quality Control Nurse Infection Control Nursing Administrator Associate Nurse Director of Nonclinica

C Professional O Performance M (standards,PR) M Quality Assurance Clerical Services Clinical Nursing Division Coordinators I Infection Control T Patient Care T (Policies, procedures) E Knowledge and Staff Personnel Service E Development S (continuing education/research) Nursing Opportunities (retention, recruitment) Budget and Suppli Primary Nurse Case Managers Nonclinical (support staff, budget, equipment specifications) Information Syst Ancillary Nursing Staff


Shared Governance

NCBH Nursing Organizational Framework Organizational Structurep hi s er cil d ea o u n L C

Pr a Co ctic un e cil

Pr of es si on a

lD ev el o

Coordinatin g Councilpm eny lit cil ua un Q o C



ou nc il

Sample nursing council in a shared governance model

Participatory ManagementFoundation for shared governance

Implies that others are allowed to participate in

decision making over which someone has control. the act of allowing participation identifies the real and final authority for the participant.


SELF-GOVERNANCE Places autonomy, authority, and control for

services to clients with the professionals providing care.

Corporate ModelA corporation is a group of people who act

as one body. Corporations may be private or public; proprietary or non-for-profit For nursing service to be a corporate entity, it must be able to sustain its own activities without dependence.

Inter-organizational RelationshipsHealth care organizations have been forming

relationships with one another to survive the increases competition for resources. Horizontal

integration occurs when organizations provides the same or similar service. (e.g. one provides laundry service while the other provides dietary service for both organizations.

Inter-organizational RelationshipsVertical Integration is an arrangement among

dissimilar but related organizations provide a continuum of care.


(e.g. affiliation of a health maintenance organization with a pharmacy, hospital, home care, and long term health facility.

MERGERSMeans that one organization will join its asset

with another .2000s Top 10 M&A deals worldwide by value from 2000 to : 2009

Rank 2 6 8

Year 2000 2009 2002


Transaction value ( in Glaxo SmithKline Beecham ) 75 , 961 mil . USD Wellcome Plc . Pfizer Inc . Wyeth 68 , 000 Plc . Pfizer Inc . Pharmacia 59 , 515 Corporation


Health Care NetworksHealth Maintenance Organizations (HMO) Associationsof health care professionals and facilities that provides a health care package for a fixed sum of money that was paid in advance for a specific period of time Preferred Provider Organization (PPO)

Groups of Provides health care insurance professionals coverage, and hospitals health care that services contractswith rates, and the employer , bill a fee for insurance services. company and other thirdparty payer to provide health care to a group.

Individual Practice Association (IPA)

Physicial Hospital Management Organization Service (PHO) Organizations (MSO)

Allows a hospital and medical staff to have joint managed care contracts.

Provide medical practice management, physician recruitment, informations system, billing and collection system, quality monitoring, and other services.

Integrated Healthcare System Main objective is to keep people healthy at the

lowest cost setting when necessary.

Improving healthcare outcomes and reduce

health care cost while improving patient satisfaction.