Exam 3 content: Organizational Structure (Ch. 12)

Question 1

what are organizations?

Answer 1

Involves establishing a formal structure that provides the best possible coordination or use of resources

An organization is formed when the number of workers is large enough to require a supervisor

We need to learn how organizations are structured…formation, communication, authority, decision-making

Question 2

what is the definition of organizational structure?

Answer 2

the way in which the group is formed, lines of communication, and means for channeling authority and making decisions

Question 3

what is the definition of formal structure?

Answer 3

departmentalization and work division: defines managerial authority, responsibility, and accountability. Relationships are defined, procedures are outlined, equipment is ready, tasks are assigned.

Question 4

what is the definition of informal structure?

Answer 4

generally social with blurred or shifting lines of authority. It is not structured or organized. Unplanned.

Question 5

what does each organization have?

Answer 5

formal and informal structure

Question 6

who created organizational theory?

Answer 6

Max Weber

Question 7

what should you know about organizational theory?

Answer 7

Max Weber - father of organizational theory

Introduced Bureaucracy

Saw large growths of organizations and predicted that the growth needs a formal, set of procedures and administrators

Published the statement-bureaucracy…one of the most influential statements on the subject

Question 8

what are the components of organizational structure?

Answer 8

Clear division of labor

A well-defined hierarchy of authority that exists in which superiors are separated from subordinates

Impersonal rules and impersonality of interpersonal relationships

A system of procedures for dealing with work situations must exist

A system of rules covering the rights and duties of each position in place

Selection for employment and promotion is based on technical competence

Weber created the organizational chart

The organizational chart depicts relationships-seen by vertical and horizontal lines

Horizontal lines-similar responsibilities and power but different functions

Vertical lines-denotes the official chain of command
The greatest decision-making authority is at the top. Those with the least are at the bottom

Question 9

what are the advantages of organizational structure?

Answer 9

Clear lines of authority

Authority and responsibility clearly defined

Clear rules and regulations

Task specialization and division of labor

Technical efficiency

Promotion based on competence

Question 10

what are the disadvantages of organizational structure?

Answer 10

Predisposed to authoritarian leadership style
Use of rewards and punishment
Competition for the advancement of individual interest
Faceless decision making
Impersonal management
Lack of flexibility
Lack of accountability

Question 11

what should you know about “unity of command”?

Answer 11

Indicated by the vertical solid line between positions on the organizational chart

One person-one boss

Its difficult to maintain in some large health care organizations because the nature of health care requires a multidisciplinary approach

Nurses often feel they have many bosses, such as the patient, family, physician, central administration

Question 12

what should you know about “span of control”?

Answer 12

• The number of people directly reporting to any one manager represents that manager’s span of control
• Research suggests should be 3-50 employees
• Optimal span of control depends on manager’s abilities, employees maturity, task complexity, geographic location
• Too many people reporting to a single manager delays decision-making
• Too few results in an inefficient, top-heavy organization

Question 13

what are examples of top management level? what are the responsibilities and focus?

Answer 13

Examples:
Chief Nursing Officer (CNO)
Chief Executive Officer (CEO)
Chief Financial Officer (CFO)

Responsibilities:
Look at organization as a whole and external influences

Focus:
Strategic planning

Question 14

what is the communication flow in top level management?

Answer 14

Top-down, receives feed back from subordinates directly & via middle mgt.

Question 15

what are examples of middle management? what are their responsibilities and focus?

Answer 15

Examples:
Unit Supervisor, Department Head, Director

Responsibilities:
Integrating unit-level day-to-day needs with organization needs

Focus:
Long & short-term planning

Question 16

what is the communication flow in middle management?

Answer 16

Upward & downward with great centrality

Question 17

what are the examples of first level management? what are their responsibilities and focus?

Answer 17

Examples:
Charge Nurse, Team Leader, Primary Nurse

Responsibilities:
Day to day needs at unit level

Focus:
Short range operational planning

Question 18

what is the communication flow in first level management?

Answer 18

Mostly upward, relies on middle mangers to transmit to top level mgr.

Question 19

what are organizational charts characteristics?

Answer 19

Depict formal relationships

Becomes obsolete (Dynamic environment)

Depict how things are supposed to be

Rigid definition of jobs

Defines authority, but not responsibility or accountability

Question 20

what are the advantages of organizational structure?

Answer 20

Map lines of decision making authority, helps one understand assignments, reveals how one fits in the organization, contributes to sound organizational structure, shows formal lines of communication

Question 21

what are the limitations of organizational structure?

Answer 21

shows only formal relationships, does not indicate degree of authority, may show things as they are suppose to be but not as they are, possibility of confusion with status

Question 22

what is informal organization?

Answer 22

Not depicted on formal chart

Element of every organization

Includes: Employees, interpersonal relationships, groups formed, & leaders

Provide workers with a sense of belonging

Great deal of power

Establish norms & behaviors

Evolve from social activities & relationships

Question 23

what are the different types of organizational structures?

Answer 23

Affects communication patterns, relationships, and authority

Ad Hoc Design: Modification of Bureaucratic structure, used on temporary basis to complete task

Matrix Structure: Designed to focus on product (end result) & function (tasks that produce product. Formal vertical & horizontal Chain of command. Good patient outcomes are products, staff education & adequate staffing are functions.

Line Structure: Bureaucratic design (Weber), used in large HCO’s,

Service Line organization: Similar to matrix, used to address shortcomings in large organizations, Care centered organization, smaller than bureaucratic.

Flat Designs: Removes hierarchical layers, flattens the chain of command, decentralizes the organization, & more authority where is done

Question 24

what should you know about stakeholders?

Answer 24

Play a role in the organizations health and performance

Have interest in what the organization does.

Internal: Board of Directors, patients, families, employees, & Physicians.

External: Local businesses, Colleges/ Universities, Insurance companies, community leaders & professional organizations.

Question 25

what is the definition of organizational culture? what does it include? what is it based on?

Answer 25

Definition: values & behaviors that contribute to the unique social & psychological environment of an organization.

Includes: the organization’s expectations, experiences, philosophy, values, self-image, inner workings, interactions with outside world.

Based on: Shared attitudes, beliefs, customs, written & unwritten rules

Mgr. should create & maintain a constructive culture

Question 26

what is shared governance? what should you know about it?

Answer 26

Organizational Design for the 21st Century

Innovative & empowering organization structure.

Developed as an alternative to traditional bureaucratic structure.

Flat organization shared among board members, nurses, physicians, & management.

Joint practice committees: assume the power & accountability for decision making.

Participatory management: Others allowed to participate in decision making

Question 27

what is magnet designation? what should you know about it? why is it important to nursing and hospitals?

Answer 27

Pathway to Excellence

American Academy of Nursing (AAN) conducted research to identify the characteristics of hospitals that successfully recruit & retain nurses (Magnet)

They determined that high performing hospitals with well qualified nurse executives in a decentralized environment with organizations that encouraged open, participatory management.

ANA established American Credentialing Center (ANCC) to recognize high performing hospitals.

ANA Board of Directors approved the Magnet Hospital Recognition Program for excellence in nursing services.

Magnet is a credential of organizational recognition of nursing excellence.

Question 28

what should you know about how a Magnet status is obtained?

Answer 28

6.9% of hospitals have achieved Magnet Recognition
The process is intense and complex
The hospital must create and promote a professional practice culture.
The hospital must apply to the ANCC, submit comprehensive documentation that demonstrates its adherence to ANA scope and standards
Undergo a multi-day onsite evaluation to verify the information and assess presence of 14 forces of magnetism.
Magnet status awarded for 4-yr period.

Question 29

what are magnet status drivers?

Answer 29

Clear link between designation & improved outcomes.

U.S News & World Report utilizes magnet designation as a primary competence indicator in assessment of 5,000 hospitals to rank & report the best hospitals.

Pathway to excellence- ANCC recognizes healthcare organizations & long –term institutions for positive practice environments where nurses excel
~ Through review process, & 12 practice standards

Question 30

what should you know about committee structure in an organization?

Answer 30

To compensate for difficult organization communication.

To facilitate upward communication.

Assist with Mgt. functions.

Advisory, coordinating & informal functions.
Establishes mechanisms to involve staff in organization governance.

Generate ideas and strategies to problems.

Question 31

what should you know about integrating L&M in organizational structure (OS)?

Answer 31

Use OS as roadmap for how organizations work.

Ensure that subordinates understand OS.

Provide staff with advisory support to carry out roles.

Encourage proper use of chain of command.

Evaluate OS effectiveness.

Encourage all staff to participate on committees.