Organizational Structure and Nursing Leadership - Essay Example

Introduction With the increased awareness of the organizations studies, it has also become increasingly important that companies evaluate their structure, climate, and culture to ensure that they don’t hinder the organization’s objectives and goals. Studies show that organization performance is highly affected by its structure Phegan (2000) stress this point when he points out that an organization structure and culture defines how work is done in an organization. Organizational studies can be defined as study of organization from different perspectives, techniques, and using various standards of analysis. For example that study may focus on micro behaviour of the organization or the macro study of the organization. The Hospital chosen This paper will be based on the New York City’s public Hospital System (HHC) is the biggest municipal public hospital and a health care system in the country; it has its central office at 125 worth street in New York. The hospital system boosts of 7,407 beds with clinical visits of more than 4 million patients visiting the facilities very year. The hospital estimates show that the hospital is worth $5.4 billion and it serves more than 1.3 new Yorkers and more than 400,000 people who have no medical insurance. the HHC provides health care, mental care and offers services in substance abuse, this is done through the HHC’s 11 acute care hospital, nursing facilities, six big diagnostic and treatment units and over 80 community based clinics located in various location around the city. The health facility also provides home care services to new Yorkers. (HHC 2007) Organization structure Organization structure can be defined as the way the organization management is arrangement, different organization structures are employed in different organization pending to various aspects that includes size of the organization, or type of the products the organization is dealing. New York City’s public Hospital System (HHC) has an organization structure which is based on divisional structure. This type organization structure is formed in a manner which allows the organization to split the organization into small self managed divisions which operates with some independence. This type of organization structure has allowed the hospital units to perform their duties without hindrance. (Phegan, 2000) Below is the organization structure of New York City’s public Hospital System (HHC) Mission The mission statement of the hospital is underlined below; To provide equally to all people in New York, without regarding their capability of paying, a high quality, comprehensive health care services in a surrounding of care, humane, respect and dignity. To advance and protect, as both advocate and innovator of health, well-being and safety of the New Yorkers; To join together with other health workers and the societies in a joint venture which will ensure that each of the institutions support and care for health services in it’s fullest aspect., of total physical, social and mental well- being of individuals. (HHC, 2007) Strategic objectives HHC has a number of strategic objectives to make sure that the Hospital continuous improving and making innovations which have discerned the public hospital system. These strategic objectives are; Patient safety; the HHC has long term campaign of reducing medical errors, preventing infections, cardiac arrests and pneumonia. Quality and safety performance; HHC invites the public to scrutinize its quality records and to make comparisons. Access to healthcare; to provide quality health care to all people in New York Technology; HHC puts a lot of emphasizes technology and taken its place in medical innovation through investing in new, integrated technology in all its facilities. Modernization; HHC has an in progress capital program to make sure that its public hospital do continue to offer the latest medical treatment. (HHC, 2007) Organization culture and climate Each organization has a different organization culture and climate; organization culture can be defined as the way activities are performed in an organization. This encompasses values, beliefs, attitudes and experiences of an organization. Black (2003) explains organization culture as precise collection of norms and values that people and groups share in an organization, which directs the manner they interact with one another and with organization’s stakeholders. Values of an organization are ideas and beliefs about what types of aspirations members should employ to attain these aspirations. Values organizations creates the norms of the organization, expectations or guidelines which, prescribe suitable types of conduct by employees in certain situations and organize the conduct of organizational employees towards each other. (Black, 2003) The organization climate and its culture can determine the success or failure of an organization to achieve its stated mission and objectives. Culture of an organization defines an organization since it a collective beliefs and ideology shared by the employees working in an organization. Phegan, (2000) also clearly defines organizational culture as “the values, beliefs and norms expressed in actual practices and behaviours of the organization’s members.” To Phegan (2000) culture is the main motivating force that ensures the success of an organization; culture also determines and represents organizational values. Culture of an organization thus, highly contributes to the how efficient the organization will be. Culture that inspires it employees also promotes to the success of the organization. (Phegan, 2000) Organization climate Organization climate can be defined as, the employees’ feelings about how they see or perceive the organization they are working in. The feeling of the employees can usually be changed within a period of hours, days or even weeks. Employees get these perceptions from both the management and their fellow workmates, either formally or informally. Perceptions are conveyed to them through observing how the management acts and models, and what the leaders encourage or ignore. For, example an employee may have a feeling that better customer care services need to provide by the organization in order to achieve more. The employee then can take an initiative of helping the organization to undertaking better customer care. (Phegan, 2000) Effects of the hospital organization’s structure, climate and culture on the development of each of the following aspects; Communication channels The hospital has created a professionalism culture and working climate which has created good feeling among its workforce, thus creating good communication channels. The hospital also has a well organizational structure allows communication channels to move from down to the top without and hindrance. The word “organization communication” is normally used by enterprises to mean the process that is used to facilitate the exchange of information and knowledge of the enterprise with its internal and external publics or individuals that have a direct relationship with the firm. This process is normally applied in the internal communications management as from the sharing of the knowledge to decision making with employees, suppliers, investors and the firms partners. In addition, the hospital strong values of justice and respect to all employees have ensured that communication between its employees is open and free flowing. (O'Donovan, 2006) The hospital stresses sharing of information, experience and ideas among its employees and patients both internally and externally. Under which, the internal communication influences each other within the company, while the external communication is used to inform and influence other people and organizations. The objectives of these communications is to inform and influence other people, promote policy change, raise funds, to monitor progress and to revise plans and to leave experience documented for the future of the firm. The hospital management plays this role effectively by; instilling a clear sense of interdependence among the its workforce who are always interested in benefiting from the hospital’s success, therefore the hospital puts more efforts in communicating with its employees openly and often with a compassion, since the management team regards having a better communication as emerging to a better understanding and more trust among the company and the other people. (O'Donovan, 2006) O'Donovan (2006) observes that many communication problems in organizations result from poor structural planning of the employees by the managers, such problems include; confusion about the level of power in an organization and also about the remuneration systems, late issue of job descriptions and contracts, also the lack of adequate and timely introduction of new employees in the organization, here we find that HHC looks for people who are well qualified and defines their duties well. Whereby its employees communicate openly as they have a good felling about the hospital. In general communication in the hospital between its workforce, patients and the management is free flowing and has seen the hospital reach high heights in its service delivery. (O'Donovan, 2006) Nursing leadership Leadership is all about motivating people or a group towards achievement of the organizational goals. In this case, it is not just one person that is motivated. It involves mutual influence between people. Employees can be influenced through incentives, teamwork, individual dynamics and discipline. The main reason is to channel all the employees’ behaviours towards the attainment of the organizations’ goals. Therefore leadership is important in maintaining a healthy organizational culture. Leading doesn’t necessarily have to be done by the person in power in the organization. Rather any person in the organization can lead. This is by being influential to the rest of the team. He or she can provide information and give suggestions on the achievement of the set goals. Leadership plays a key role in the success of an organization. (O'Donovan, 2006) In the HHC setup, nursing leadership has been encouraged by the management. The management has created a structure, culture and climate that give equally opportunities to all employees working in the hospital. The hospital stresses leadership behaviour in work include; directive, supportive, participate and achievement oriented. The managed is concerned with employees’ feelings and making things pleasant for the employees and defining tasks requirements and other aspects of the work agenda. This highly encourages leadership among the nurses working in the hospital. (O'Donovan, 2006) The hospital management structure and culture encourages creation of team leadership in this case, every one is expected to have high degree of interdependence geared towards achievement of complexion of duties allocated. A leader within a team is expected to stand apart from the team by virtue of position held and help team members in clarification of issues, advocating for members where there is injustice. In finding solutions team leader is supposed to clearly understand the issue and its possible solutions. These are then formulated and address to relevant authorities for action to taken. This is characteristics of a team leadership where a leader gets commitment from individual members to take action on issues concerning them. The hospital through its value of being a leader in research and innovation creates and encourages the nurses working in this hospital to take leadership initiative through research and innovations that they can develop. Through training that is carried out by the hospital management nurses are able to get opportunity to further their leadership skills and knowledge. The hospital culture of professionalism also encourages nurses to take up leadership opportunities; this thus, has encouraged nursing leadership in the hospital. Nursing care delivery system HHC is well known for its quality and excellence in service delivery and for offering better health care services. This can not be achieved in an organization which is not well structured and which does not have a strong organization culture. Different aspects in the hospital structure can be attributed the good nursing service delivery. Some of these aspects can be outlined below. Well defined management structure The hospital has well defined management structure such that the management functions within the hospital are carefully designed to fit the way health care is provided in the hospitals. For example, the employees know what they are expected from them in the course of their duties and who are their supervisors. Such a move has ensured reduction of conflicts between management and the employees in the hospital since the hospital structure is clear on how things are done in the hospital. This has highly motivated the staff working in the hospital ensuring better service delivery. (O'Donovan, 2006) Language and communication Communication is notably the most important factor and step required for the achievement of improved degree of satisfaction among various groups of employees. Good communication structure of the hospital has ensured that employees freely and easily communicate to each other and the managed. Good communication also has ensured that conflicts does not arise which normally disrupts service delivery. Managers who use simple but powerful words usually win the hearths of most employees. How a manager expresses himself while communicating the company’s principles determines the mode of reception from the employees themselves. The hospital culture of respecting each other also has ensured employees value respect each other, thus, ensuring good service delivery. (O'Donovan, 2006) Promotion and career advancement The hospital has set up an organizational structure which encourages promotional based on merit and experience. Proper career advancement policies of the hospitals ensure that each employee works hard to advance his/her career development. In turn this is translated to improved service delivery. The positive climate being experienced by all staff members including the subordinate staff members also has continued to create an improvement in health care delivery. (Hill, and Jones, 2001) Safety in the work environment People who feel safe in their working environment tend to perform better than those who don’t. Safety can be in the form of human-machine relations and human-human relations. The hospital has created a culture and climate that makes the employees to feel safe, this highly motivates employees and improves their production and consequently improves the nursing service delivery of the hospital. (Hill, and Jones, 2001) Strategies that could be implemented to improve or maintain the hospital Though, HHC has been is accredited with success in its health care providence undertakings there are various improvements that the organization needs to embark on so that it can enhance its continuity of improvement in the contemporary heath care sector. The hospital needs to understand clearly the aspect of management. The Hospital should integrate the planning, organizing, directing, and controlling functions of the organization in order to boost the hospital’s organizational effectiveness. Proper training to all managers and the employees should be conducted in order to avoid any conflicts that may arise in the course of the hospital’s activities. (Hill, and Jones, 2001) Compensation and Motivation Legge (2004), points out that, with continuous changing perception, money is no longer the sole motivating factor for an employee in an organization. The workforce today is much more educated and specialized in their field, thus, employees are becoming more concerned with job satisfaction, participation, involvement and other factors besides financial benefits. Therefore, HHC has to come up with strategies which will inspire the workers so that they give their best. The hospital has to attend to the financial and psychological needs of the workers by rewarding them well. Basic financial remunerations only is not enough the hospital has to include psychological fulfilment to ensure that employees are continue to be motivated to ensure continuous high service delivery. (Legge, 2004) Regularly training of staff Each employee requires more learning in order to improve his /her skills, no matter how best an employee is, he/she can not be 100% percent qualified. Thus, the HHC management should implement more training programs and systems that can continuously update it staff on new technologies and regulations in the health care and improve the overall performance of the hospital. (Hill, and Jones, 2001) Conclusion Organization behaviour and structure has increasingly become important in the contemporary business world. Research shows that over 80% of organizations that collapse is due to poor organization structures. Proper organization structures allow effective and efficient management avoiding frictions that are associated with poor management structure. Organization culture and climate determines the way things are done in the organization and how the workers feel about the organization. A strong organization culture insures that the organization performance is achieved. However, communication, motivation and regular training also will go along way in improving the workforce performance. Thus it is important that HHC hospital undertakes the above outlined measures to continue achieving its goals and objectives. References; Black, R. J. (2003): Organizational Culture: Creating the Influence Needed for Strategic Success, London UK, HHC (2007): About HHC; Retrieved from: www.nyc.gov/html/hhc/html. Accessed on 9/10/07 Hill, C. W and Jones, G. R (2001): Strategic Management. Houghton Mifflin Hofstede, G (1980): Culture's Consequences: International Differences in Work Related Values, Beverly Hills, CA, Sage Publications Legge, K (2004): Human Resource Management: Rhetoric and Realities. Anniversary Ed. Hampshire: Palgrave Macmillan, Murray, ME & DiCroce, H.R (2003): Leadership and management in nursing, 3rd edition, Prentice Hall, New Jersey. O'Donovan, G (2006): The Corporate Culture Handbook: How to Plan, Implement and Measure a Successful Culture Change Program, The Liffey Press, Phegan, B. (2000): Developing Your Company Culture; a Handbook for Leaders and Managers, Context Press, Appendix The Health Care Environmental Checklist Directions: Check "yes" or "no" to the list of attributes to determine to what extent your organization/complex is consistent with the stated priorities for today's health care. Attribute Yes No • Wellness and prevention programs are offered to the public.   • Patients are discharged in a timely manner.   • Case management is the system of nursing care delivered   for inpatient and outpatient care.   • Home care services are provided.   • Ambulatory or outpatient surgery services are offered.   • Opportunities exist for Advanced Practice Nurses.   • Standardization of medical and nursing care plans are in effect   using critical paths and evidence-based care. • Skilled nursing units are available.   Read More