N 205 organizational structures

Question 1

Organizations are…

Answer 1

formally constituted groups of people who have identified tasks and who work together to achieve a specific purpose

-Organizations are structured or organized to : Assist individuals to work together to achieve a common purpose

Question 2

Nurses are part of organizations such as

Answer 2

hospitals, public health units, home care, private homes etc. It is the role of the professional nurse to influence the organizational processes to have a successful practice

Question 3

An organizational structure is the framework for

Answer 3

working relationships among members of the system. Each organization has a formal and informal structure

Question 4

**Characteristics of an organization include:4

Answer 4

1. Common Goal
2. Coordination of Effort- doc, nurse, OT
3. Division of labor- RN, LPN, care aid
4. Established delegation of authority-manager

Question 5

**Organizational Structure: refers to

Answer 5

how a group is formed and is the formal relationship within each organization
-The structure’s goal is to achieve the mission, vision and philosophy of the organization

Question 6

Characteristics of Organizational Structures:5

Answer 6

1. Complexity- Vancouver vs. Chilliwack. specialization of labor
2. Size- Pts in hallway. larger = more complex
3. Geographical dispersion-after hope, closest hosp. physical location
4. Formalization-Policies and rules. vary btwn institutions
5. Centralization- location where a decision is made

Question 7

Mission:

Answer 7

the purpose of the organization. It outlines the organizations primary plans or driving forces. They can often incorporate statements of philosophy.
-express what an organization plans to accomplish

Question 8

Vision

Answer 8

provides a conceptual view of what the future of the organization desires to look like
ex. To be the premier neurosurgical nursing unit in the province

Question 9

Philosophy

Answer 9

general imbedded into mission statement. Belief system

Question 10

Values

Answer 10

largely describe the organizations boundaries while pursuing the vision. Describes the boundaries

Question 11

organizational theory

1. Classic (Bureaucratic) :

Answer 11

1900’s goal was high production, efficiency and profit. Communication –top to bottom
**focus is on the organization and making money

Question 12

organizational theory

2. Humanistic:

Answer 12

1930’s goal was economic, productivity, profit job satisfaction led to improved production. Communication was vertical, participation of workers
**focus is on the organization and individual

Question 13

organizational theory

3.Modern :

Answer 13

1950’s goal interdependence of individuals to meet a common goal, communication was horizontal and vertical. Organization and worker are seen as a whole
**focus is on the organization and individual, environment, role arrangements, status etc.

Question 14

Types of organizational structures:
1. Centralized (tall)
txt- functional

Answer 14

Location where decisions are made. Usually by a few individuals at the top of the organization I.e. major decisions made by the vice president of patient care.
CEO
Tech- Prof services- finance- human resources- nursing service
–professional service to, resp therapy, dietary, pharm…
–nursing service to- surg, peds, medicine, obstetrics

advan-allows for close coordination and encourages advancement
-workers just listen to the boss and are not very creative

disadvantage- slow communication, expensive, messages don’t get to the top often, rqrs many managers

Question 15

Types of organizational structures:

2. Decentralized (flat)

Answer 15

decisions are made by the professionals that are doing the work i.e. Unit Manager, head nurse- head nurse- head nurse— removal of hierarchy layers

advan- better communication, job satisfaction, less supervision, less distorted messages. informal power can bypass PCC to manager.

disadvan can lack knowledge in areas responsible for ex. might not have wound care nurse, increased pressure with increased authority and responsibility.

Question 16

Types of structures:

3 Matrix

Answer 16

may combine a tall and flat. There are often two directions for authority, accountability and communication i.e. financial services, quality assurance, etc.
-president to all vice pres, vice pres to directors of departments… ex apple- team within a team

advan- increased flexibility, assistance from experts

disadvan- feels like you don’t have one boss-have many

Question 17

**Organizational chart structures-division of labor

Answer 17

1. chain of command-path of authority
   a) scalar process-the vertical growth. the more steps there are the more centralized the decision making is. Hierarchy.
   b) Functionalization-horizontal growth. different kinds of duties at the same level
2. Span of Control- refers to # of ppl a manager is supervising.
   a) Narrow/short- few ppl/tasks, 3-5 subordinates. allows for more to control (tall structure).
   b) Broad/wide- many ppl and tasks, decreased control (flat structure)
3. Service line features-
   a) line function- hierarchy of personnel that is from executive to workers at bottom. Involves direct responsibility to meet objectives. Have authority for decision making. USE SOLID HORIZONTAL AND VERTICAL LINESb) Staff function- may assist line positions, provide support, advise and counsel. Staff positions are recognized through BROKEN LINES

Question 18

**Models of care delivery 6:

Answer 18

1. Total PT care or case method
2. Functional Method
3. Team method
4. Primary method
5. Nursing case management
6. Emerging Models

Question 19

• *Models of care delivery 6:

1. Total PT care or case model advan/ dis

Answer 19

oldest known model. nurse/PT ratio 1:1
each. mostly in high acuity.
advan- consistent, holistic care. subtle changes noted quickly, very useful with complex PTs

disadvan- expensive, not ideal with nursing shortage

Question 20

• *Models of care delivery 6

2. Functional Model

Answer 20

each employee has a designated task, skills and activities. ex. wound care nurse sees all PTs
advan- efficiency, unskilled workers can be trained to do specific tasks, can give care to larger # PTS (cost effective)

disad- fragmentation care, confusion to PTs, critical changes may go unnoticed, poor communication lines

Question 21

• *Models of care delivery 6

3. Team Model

Answer 21

Each unit will have two or more teams to provide care to a geographic location of PTs. each team has various educated providers RN, LPN, RCA.
advan- improved PT satisfaction, cost effective, work with multiple levels of HC

disadvan- if team leader has poor communication/leadership skills, duplication of care, need time for conferencing

Question 22

• *Models of care delivery 6

4. Primary model

Answer 22

One nurse functions as the PTs primary caregiver throughout their entire stay. RN plans and delivers all care.
advan- increased quality of care-nurses educate selves to provide optimal care for PTs.
-increased job satisfaction
-establish relationship with family and PT
-decreased # of unlicensed personnel

disad- lack of experience or education of RN, shorter stays, large # of part time RNs

• RN are held accountable eve if not physically present for 24hr responsibility of care
• costly

Question 23

• *Models of care delivery 6

5. Nursing case management

Answer 23

get PTs home sooner.
identification of a critical pathway for care and treatment. RNs most often act as the case managers.
advan- Pt receive more services & have fewer unmet needs, cost effective, better pt monitoring and decreased complications, nurse satisfaction.

disad- duplication of services, turf wars b/t services ex. RN and social worker.
-bad if widow gets sent home too soon and has no one there to help

Question 24

• *Models of care delivery 6

6. Emerging models

Answer 24

growing partnership or collaborative models. ensure delivery of right care by right provider. need to ensure effective and efficient utilization for all health care team members.
advan-cost effective, uses innovative approaches with new technology

disadva- roles of RNs and LPN are not clear, LPN must have PT who is stable with predictable outcomes
-both groups focus on tasks and activities blurring their roles