organizational structure in nursing managements

Organisational structure

1. Govt. College Of Nursing, Rajnandgaon(C.G.) Subject: Nursing Management Seminar on: Organizational structure SUBMITTED TO DR. MRS. UMA SHENDEY PROFESSOR DEPARTMENT O F CHILD HEALTH NURSING GOVERNMENT COLLEGE OF NURSING RAJNANDGAON (C.G.) SUBMITTED BY M R S. CHANDRIKA SAHU M.Sc. NURSING 2 ND YEAR GOVERNMENT COLLEGE OF NURSING RAJNANDGAON (C.G.)

2. All Organizations have a management structure that determines the relationships between functions and positions and subdivides and delegates roles, responsibilities and authority to carry out defined tasks. It is a framework within which an Organization arranges its lines of authorities and communications and allocates rights and duties. Introduction

3. Definition of Organization According to Luther Gullick : “Organization is a formal structure of authority through which work sub-divisions are arranged, defined and coordinated for the defined objective.” According to Chester I Bernard: “Organization is a system of cooperative activities of two or more persons.”

4. The organization must 1) Reflect objectives and plans of the organization. 2) Reflect the authority available to various categories of managers belonging to different management levels. 3) Reflect its environment. 4) Be manned with trained and appropriate people, commensurate with their job requirements. Concept of Organization

5. Identify what the business aim to achieve. Give the business a sense of direction. Provide focus to everyone in organization. Drive decision making and strategy planning. Motivate employees. Objectives of Organization

6. Principle of chain of command: Communication flows through the chain of command or channel of communication tends to be one way downward. The communication flows freely in all directions, with authority and responsibility delegated to the lowest operational level. 2. Principle of unity of command: Also called principle of responsibility. The organizational set up should be arranged in such a way that a subordinate should receive the instruction or direction from one authority or boss. In the absence of unity of command, the subordinate may neglect his duties. It will result in the non completion of any work. There is no guidance available to the subordinates and there is no controlling power for the top executives of the organization. Principles of Organization

7. 3. Principle of span of control: Span of control refers to the maximum number of members effectively supervised by a single individual. (The number of members may be increased or decreased according to the nature of work done by the subordinates or the ability of the supervisor. The span of control enables smooth functioning of the organization. 4. Principle of specialization or division of work: Specialization is the best way to use individuals and groups. Division of work means that the entire activities of the organization are suitably grouped into departments and sections. (The dept and sections may be further divided into several such units so as to ensure maximum efficiency).

8. 5. Hierarchy or scalar chain It is the order of rank from top to bottom in an organization. This is also called a chain of command or line authority. (Normally, the line of authority flows from the top level to bottom level. It also establishes the line of communication). 6. Centrality: It relates to the position or distance the person has on the organizational chart from other workers. 7. Unity of objectives: This principle dictates that it is essential for the organizational objectives to be formulated in clear, unambiguous, achievable and measurable terms which should be understood by all concerned.

9. 8. Definition of jobs/ principle of definition: It is necessary to define and fix duties, responsibilities and authority of each worker. 9. Principle of balance: There are several units functioning separately under one organizational set up. The work of one unit might have been commenced after the completion of the work by another unit.

10. 10. Principle of equilibrium balance: In certain periods, some sections or departments are overloaded and some departments are under loaded. The overloaded sections or departments can be further divided into subsections or sub departments. 11. Principle of continuity: Administration is a continuing or ongoing process – recycling the structure of the organization based on the economic, environmental and socio-political changes.

11. 12. Principle of unity of direction: The major plan is divided into sub plans. Each sub plan is taken up by a particular group or department. All the groups or departments are requested to cooperate to attain the main objectives or in implementing major plan of the organization. 13. Principle of communication: A two way communication flow from top to bottom levels and from bottom to top levels is a prerequisite to obtain an effective organizational set up.

12. 14. Principle of flexibility: To meet the challenges of the increasing and changing demands of the environment, an organization structure is subjected to change. As such rigidity has to be avoided and flexibility is essential in the organization structure, so that changes can be brought about without disrupting basic design of the structure.

13. Clarity: Nurses need to know -Where they belong, -Where they stand in relation to the quality and quantity of their performances -Where to go for assistance. Economy: All the organization should have well economy or financial infrastructure their source of income govt. political parties and the money which is for providing salary for the staff. The organization should have the pay matrix level under guidelines of govt. M inimum requirements for Organization

14. Direction of vision: Nurse managers must direct their vision and that of their employees -Toward performance, -Toward the future and -Toward strength. Decision making: Nurses should be organized to make decisions on the right issues and at the right levels. They should be organized to convert their decisions into work and accomplishments.

15. Stability and Accountability: Nurses should be organized to feel community belongingness. They can adapt to show objectives requiring changes in their functions and productivity. Perception and Self renewal: Nursing services should be organized to produce future leaders. The organizational structure should produce continuous learning for the job each nurse holds and for promotion.

16. Organizational Structure

17. Why do we need an Organizational Structure ? All Organizations have a management structure that determines the relationships between functions and positions and subdivides and delegates roles, responsibilities and authority to carry out defined tasks.

18. Organizational Structure It is a framework within which an Organization arranges it’s lines of authorities and communications and allocates rights and duties.

19. Definition An organizational structure is a system that outlines how certain activities are directed in order to achieve the goals of an organization. These activities can include rules, roles and responsibilities.

20. Development of an organizational structure 1. Clear Definition of Objectives 2. Identification and Grouping of Activities 3. Determination of the Structure 4. Revision of the Structure

21. 1. Clear Definition of Objectives: Achievement of goals can be made possible only with unique organization structure derived from standard structure layout. 2. Identification and Grouping of Activities : The next step here is to identify activities that members of the organization have to perform. Since every business activity requires many tasks, clear identification of them is important. After identification, it is necessary to group these activities into classes on the basis of their nature.

22. 3. Determination of the Structure: After completing the first two steps, the organizers finally determine the overall structure. He defines the ranks and hierarchy in which people will function. 4. Revision of the Structure: Once the structure starts functioning, it can show up problems and shortcomings. For example, the marketing and sales departments often perform similar functions. Consequently, this can show up difficulties in the clear demarcation of work between them.

23. Purpose of Organizational structure Divides work to be done in specific jobs & departments. Assigns tasks and responsibilities associated with individual jobs. Coordinates diverse organizational tasks. Establishes relationship b/w individuals, groups and departments. Establishes formal lines of authority. Allocates organizational resources.

24. Features of Organizational Structure Determines the manner and extent to which roles, power and responsibilities are delegated. Depends on objectives and strategies. Acts as a perspective through which individuals can see their organization and it’s environment.

25. Importance of Organizational Structure Impacts effectiveness and efficiency. Reduces redundant actions. Promotes teamwork. Improves communication. Contributes to success or failure.

26. Factors influencing organizational structure – Size of the unit: Size is an important factor governing cost, efficiency and profitability of a business enterprise. Before any business or non-business enterprise is started, the organizers will have to decide the most profitable and viable size of the unit. Job design: The bricks that build up an organization structure are jobs. Job design is the first managerial decision of the organizational structure.

27. Grouping of activities: Grouping of activities are essential to achieve coordination. Each group is termed as a department. Thus, in each and every organization, we observe departments like marketing, production and finance. In each department, we find authority relationships like finance manager, assistant finance section officer and finance supervisor. Span of control: Another factor that determines the organizational structure is the number of persons to be managed by each manager. This is called span of management. Depending upon the nature of the organization, some departments will be large in size and some will be small.

28. Delegation of authority: In an organizational structure, if the span and levels of management are more, the delegation of authority will be more and there will also be decentralization of authority for the smooth functioning of tasks.

29. Emerging trends in organizational structures Job and work patterns are changing. There is a very high mobility of workers. They move from one job to another for better prospects. The concepts of job security and steady income are losing ground. Outsourcing of employees is increasing. Part-time, contract and self-employed workers are increasing as a per cent of total employees.

30. Organizations manufacturing or trading products in global markets are restructuring their organizations. Cost-cutting and enhancing productivity have become mantras of every organization. Emphasis is on changing technology and developing entrepreneurship. Emerging organizations are virtual. This means they need not see each other every day. They communicate with each other through systems like video conferencing.

31. Types of Organizational Structure Tall or Centralized Structure. Flat or Decentralized Structure. Matrix Structure. Adhocracy Structure. Shared Governance.

32. Tall Organizational Structure Large, complex organizations often require a taller hierarchy. In its simplest form, a tall structure results in one long chain of command similar to the military. As an organization grows, the number of management levels increases and the structure grows taller. In a tall structure, managers form many ranks and each has a small area of control.

33. Medical College Hospital

34. Advantages Enables an individual to be an expert in the narrow area over which he or she is responsible. Because the supervisor has fewer people to supervise, close supervision is possible. The top level authority is the primary decision makers, and has a great deal of control over actions of others.

35. Disadvantages The most skilled individuals may end up doing nothing but supervising, whereas those less capable do the actual tasks. Those who are closely supervised may feel stifled and even mistrusted sometimes. Communication is difficult because it may pass through many layers. Implementation of decisions may excessively delay.

36. Flat Organizational Structure Flat structures have fewer management levels, with each level controlling a broad area or group. Flat organizations focus on empowering employees rather than adhering to the chain of command. By encouraging autonomy and self-direction, flat structures attempt to tap into employees, creative talents and to solve problems by collaboration.

37. Flow chart: Flat or Decentralized Structure

38. Advantages There is simplification of communication patterns, flowing easily from lower levels to higher levels in a direct manner. Greater speed with which the organization can respond to problems or new opportunities, as decisions can be made by those in the situation. Less chance of communication becoming lost or distorted as it moves within an organization.

39. Disadvantages Managers may lack expertise in wide variety of operations for which they are responsible and thus make inappropriate decisions. If individuals within the organization are not competent their inappropriate decisions and actions may do great harm.

40. Matrix Organizational Structure These structures are most often found in very large, multifaceted organizations. Many organizations try to apply principles of business to health care. This resulted in the organization of areas around product lines (which focuses on end product of health care) and service line (represents the tasks required to accomplish the delivery of the product.

41. PRESIDENT VICE PRESIDENT DEVELOPMENT VICE PRESIDENT MARKETING VICE PRESIDENT FINANCE HOSPITAL, CEO, DIRECTOR OF PATIENTS CARE SERVICES LONG TERM CARE ADMINISTRATOR HOME HEALTH CARE PRESIDENT VICE PRESIDENT VICE PRESIDENT DIRECTOR OF GERIATRIC SERVICES DEVELOPMENT FINANCIAL SERVICES PLANNING AND MARKETING PATIENT SERVICE DEVELOPMENT Flow chart: Matrix Structure

42. Advantages A team approach to projects or problems brings together wide expertise and often generates more creative solutions. There is flexible use of human resources. The team members learn more about one another's concerns and thus improves working relationships, functional integration. Communication is also improved by close contact with all organizational groups.

43. Disadvantages Leadership conflict. Lack of understanding of roles and expectations. Confusion, Conflict and Ambiguity. Time allocation between working for team and working for department may become an issue.

44. Adhocracy Organizational Structure This type of structure uses teams of specialists who are organized to complete a particular project or task. These groups are referred to as project team or task force. It is composed of highly specialized professionals the work is delegated by a director to members of the project team who provide particular expertise.

45. Shared Governance Struc ture It represents a professional practice model in which the nursing staff and nursing management are both involved in making decisions as opposed to having the decisions made at an administrative level only. Implementations of Shared Governance. It requires the staff nurses participate in professional development designed to increase the nurse's understanding of decision making, team building, group dynamics, leadership and budgeting.

46. SUMMARY

47. Recapitulation

48. THANK YOU