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1. Organizing 1

2. Learning objectives At the end of the session, students will be able to: Discuss why organizing is an important managerial function Discuss the functional elements of organizing Differentiate between organizational design and structure Analyze different organizational structures in the health care systems Sketch organizational chart 2

3. Introduction the managerial function of organizing defines and arranges the resources, divides work into specific jobs and tasks, groups tasks into teams or departments, assigns tasks, delegates authority, and allocates resources across the organization during the organizing process, managers coordinate employees, resources, policies, and procedures to facilitate the goals and achieve the organization’s mission making sure that you have in place the systems, procedures, and processes that make it possible to execute assigned tasks for staff. 3

4. Introduction… the organizing function is to design a structural framework that enables the institution to achieve its objectives this requires assessing the organization’s overall mission and objectives, geographic span, its size, space constraints, technology, culture and the changing environment e.g. if an organization exists in a rapidly changing environment, it may need to restructure itself often management must have an organizational strategy that can be adapted to a competitive and changing environment 4

5. Introduction… the structure of the organization will follow that strategy and will require restructuring from time to time to accommodate the board’s vision; regulatory changes; and demands for new services, technologies, and expertise the managerial function of organizing is an impersonal function because the organization is designed around its activities, not the individual personalities of those in place to perform them. designing organizational structures is a primary concern of the senior mangers 5

6. Introduction… Formal organization theory rests on six major principles Authority is the lifeblood of the managerial position & the delegation or distribution of authority makes the organization come alive The span of management sets limits on the number of subordinates a manager can effectively supervise. The division of work is essential for efficiency - division may require designing jobs (job or work specialization) The formal structure is the main network for organizing and managing the various activities of the organization - often done through departmentalization Unity of command must prevail; that is, each person should take orders from and report to only one boss. Coordinating activities and resources is a primary responsibility of management and is fulfilled by performing the managerial functions properly 6

7. Organizational structure and design organizational structure is the formal arrangement of jobs in the organization it is the overall layout of departments, positions and interrelationships the structure is displayed in the organizational chart or table of organization organization chart: a diagram that depicts the title of each manager’s position and illustrates who is accountable to whom, who has authority for each department, and what type of authority is held the principal purpose for defining the organization diagram is to clarify chain of command, span of control, official communication channels, and linkage for all department personnel 7

8. Organizational structure and design… representing the organization's structural skeleton, organization charts have dimensions representing vertical hierarchy and horizontal specialization. vertical hierarchy is the chain of command while horizontal specialization involves the division of labor the application of formal organizational principles involves all levels of management, including supervisors as individuals move up the managerial hierarchy, they are called on to participate in more and more organizational decisions 8

9. Organizational structure and design… Organization design is the creation of an organization's structure When managers develop or change an organization's structure , they are engaged in organizational design, Objectives of the design include responding to change, integrating new elements as needed, coordinating the components, and encouraging flexibility Organizational design is a process involving decisions about these key elements as: work or job specialization, departmentalization, span of control ( span of management) chain of command 9

10. Division of work job specialization is the process of breaking down a job into smaller, more specific tasks and having each part or step of the task performed by a different individual each employee specialize in doing part of an activity rather than the entire activity It creates simplified tasks, and fosters specialization This results in greater efficiency and higher production advances in medical sciences and technology result in greater specialization of health professionals, facilities and equipment - increased fragmentation of the delivery of care specialization intensifies the need for coordination and collaboration between the specialists to ensure that patients are treated for the appropriate condition 10

11. Departmentalization Once jobs have been divided up through work specialization, they have to be grouped back together so that common tasks can be coordinated Departmentalization, or compartmentalization is the process of grouping various activities into distinct units by logical arrangements. Departmentalization creates the building blocks for the formal structure, the main network for managing the various activities of the organization It overcomes some of the effect of fragmentation caused by job specialization and permits coordination (integration) to be handled in the least costly manner 11

12. Departmentalization… A department, by definition, is a unit ; it is a distinct area of activities over which a manager or supervisor has been given authority a department may be termed a division , a service , a section , a unit , a function , or a similar term, but it still represents a closely related set of activities Departmentalization relies on specialization , which is the core determinant By departmentalizing the organization, a horizontal and vertical grouping of specialized activities is attained The process of departmentalization can be done on the basis of (1) function, (2) process and equipment, (3) customer (patient), (4) product, (5) geographic location, or (6) time 12

13. Departmentalization… Function The most widely accepted practice is grouping activities with common tasks All activities that are alike or similar and involve a particular function are placed together into one department under a single chain of command takes advantage of specialization - leads to an efficient use of resources facilitates and enhances coordination compared to same function performed in several divisions facilitates in-depth skill development and allows for clear career paths 13

14. Departmentalization… Process and Equipment Activities can also be grouped around the equipment, process, customer flow, and technology involved. within a functional department, one may organize staff by process or equipment Departmentalization by function and by equipment frequently become closely allied often found in hospitals which usually operate sophisticated equipment and handle certain processes that require special installations, training, and expertise Every task involving the use of certain equipment and technology is then referred to the particular specialized department that is equipped to do the task 14

15. Departmentalization… Customer (patient) group activities based on customer (patient) needs & characteristics In a hospital, certain services and activities may be grouped for either outpatients or inpatients Some healthcare organizations have built entire facilities to specifically serve a patient type, such as women’s centers and children’s hospitals. allow the staff to specialize in treating a certain group of customer customer OR product structures? - product describes the customer a center of excellence for cancer, cardiology, orthopedics, or other specialty. the centers are product lines that treat patients who have a common condition 15

16. Departmentalization… Product is often seen in the establishment of centers of excellence (similar to customer) a division is responsible for a single product or group of closely related products For example, a hospital supply company may have three separate departments for furniture, surgical supplies, and uniforms. Product departmentalization in a healthcare facility involves the division into departments based on the “product” turned out for example, maternity, surgery, oncology, cardiology, or psychiatry Hospitals that have adopted this approach often call it a product line organization Each department has its own nursing, nutrition, maintenance and cleaning, staffs, and each product department has its own boss 16

17. Departmentalization… Territory (Geographic Location) departmentalize is by territory or according to location, which entails setting up departments based on defined geographic areas or sites a number of cities, a few blocks of a large city, or different floors in the same building Territorial departmentalization is common in national and regional healthcare systems If the same functions are performed in different locations and different buildings 17

18. Departmentalization… Time group activities according to the period during which they are performed. an institution may set up time shifts - day, afternoon, and night or only day and night. Activities typically are grouped first on some other basis, such as by function, and then are organized into shifts For example, the housekeeping team for cleaning rooms may be organized 18

19. Departmentalization… Mixed departmentalization (Composite, Hybrid Structure) The prime concern of departmentalization should be to set up departments that coordinate its functions to achieve the institution’s objectives There are advantages and disadvantages to each departmentalization method Management often uses multiple departmentalization options - hybrid structure E.g., a nursing supervisor (functional) works on the surgical unit (subfunction), in the third floor (location), during the night (time), and in the women’s center (customer) In practice, almost all hospitals have this composite type of departmental structure, combining function, location, time, and many other considerations, Any mixture is acceptable, as long as it works and is consistent with the overall objectives of the institution. 19

20. Span of management Span of management ( span of control ) - the scope of supervision, or the number of people who report to a particular manager It deals with the number of people any one person can supervise effectively Managers with a narrow span of control oversee the work of a few people, Managers with a wide span of control have many people reporting to them 20 Span of management - span of control, span of authority, span of supervision, or scope of supervision

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22. Span of management … When span of control is too broad the manager has insufficient time to observe, evaluate or give feedback make the managers overburdened, little guidance or control of employee and overlooking serious errors a feature of flat organizations (fewer management levels) Emphasize a decentralized approach to management that encourage high employee involvement in decisions. have higher employee morale and productivity ( can be hindered by little guidance) It results in quick communications, speed up decision making, and increase flexibility and efficiency 22

23. Span of management … when span of control is too narrow the manager has time to supervise each one closely too close supervision discourages subordinates problem solving, independent judgment and creative thinking 23 It is a feature of tall organizations ( consisting of hierarchies with many levels of management relative to the organization’s size) Affects the speeds of decisions (delay), managers are underutilized and in-efficient, communication gets difficult, slower to respond to changes

24. Span of management … Many factors influence the span of one’s management control Competence, skills and experience of the supervisor and the employees supervised Physical proximity of employees to each other and their supervisor Extent of time spent by the manager performing nonsupervisory duties Frequency of interaction required of employees to each other and their supervisor The degree to which standardized procedures are in place, Similarity and complexity of tasks being supervised Frequency of changes in processes Supervisor’s ability to use technology to monitor performance 24

25. Chain of command the vertical line of authority that clarifies who reports to whom throughout the organization It helps employees answer questions such as "Who do I go to if I have a problem? or to whom am I responsible?“ People higher in the chain of command have the right to give commands, take action, and make decisions concerning activities occurring anywhere below them in the chain Two important concepts: authority & unity of command Unity of command - workers should report to just one boss Without unity of command, conflicting demands and priorities from multiple bosses can create problems 25

26. Chain of command … Authority refers the right to give commands, take action, and make decisions Line or positional authority - Formal authority granted by an organization to a supervisor It reflects existing superior–subordinate relationships Staff authority - resides with those who have certain expertise and are given the right to counsel or assist those with line authority functional authority - Authority given to individuals with expertise in specialized areas and limited to particular situations. Although functional authority is limited to a specific area or topic, it is full authority and gives the staff member the right and power to give orders outside of normal authority lines in this limited area 26

27. Types of organizational structures There are different types of organizational structures the three most commonly used types of organizational structures Functional Divisional Matrix 27

28. Functional structure Classifies people according to the function they perform in their professional life the functions of a hospital include psychiatry, nursing, pharmacy, laboratory, housekeeping, and etc. grouping jobs that require the same knowledge, skills, and resources allows them to be done efficiently and promotes the development of greater expertise A disadvantage of functional groupings is that people with the same skills and knowledge may develop a narrow departmental focus and have difficulty appreciating any other view of what is important to the organization In addition, coordination of work across functional boundaries can become a difficult management challenge 28

29. Divisional structures It is based on the different divisions in the organization Product structure : All the activities necessary to produce and market a product or group of similar products are grouped together Customer/market structure: an organization may find it advantageous to organize according to the types of customers it serves Geographic structure organizations that are spread over a wide area may organize along geographic lines so that all the activities performed in a region are managed together 29

30. Matrix structures In a matrix organization, teams are formed and team members report to two or more managers Matrix structures utilize functional and divisional chains of command simultaneously in the same part of the organization. Functional departmentalization commonly is combined with product groups on a project basis matrix structure facilitates the use of highly specialized staff and equipment resources are shared as needed 30

31. Matrix structures… in some cases, highly specialized staff may divide their time among more than one project maintaining functional departments promotes functional expertise , working in project groups with experts from other functions fosters cross-fertilization of ideas the matrix organization may not allow long-term working relationships to develop, as using multiple managers for one employee may result in confusion power struggles between the functional and product manager can prevent successful implementation of matrix structural arrangements 31

32. Matrix structures… 32