ORGANIZATION &COMMUNICATION STRUCTURE

Presenter Sr. Uma Lal

REFERENCES
Yoder-Wise, P.S. (2003). Leading and managing in nursing (3rd. ed).St.Louis ,Mosby. Marquis. L. &Hutson, C.J.(2006) Leadership roles and management functions in nursing :Theory and Application (5th. ed.) Philadelphia: Lippincott Williams &Wilkins

Objectives
At the end of the lecture the student should be able to : Define the following terms : Structure Process Line Staffs relationships

Objectives
Compare formal and informal organizations in relation to : i. Structure ii. Relationships iii. Communications iv. Advantages &Disadvantages v. Demonstrate skill in drawing organizational charts of a unit

Definitions
Structure formal and informal framework of policies and rules within an organization Arranges its lines of authority and communication and allows rights and duties.
Process-a series of actions intended to achieve a particular result or change Line staff relationship- the way people who work for an organization feel and behave towards each other

Definition
Organization-open social system in which groups of people combine knowledge ,techniques ,skills and resources to accomplish a goal oriented task by integrating their structure and activities . Communication giving and receiving information via talk ,gestures ,writing ,

Organizational environment
Organizational climate and composition including stakeholders and partners Organization is a way of life Inevitable and necessary survival in a complex society Health care delivery system Various organization sizes e.g. large hospitals, Health Centers ,Nursing Stations and small clinics

How organizational environment affects nursing practice

1 .People work in groups and have a common goal 2.Consists of many interdependent parts e.g. . Physical individual workers ,formal structure ,informal work groups ,task, management process ,organizational climate ,style of leadership, other organization that directly or indirectly affect the organization

How organizational environment affects nursing practice

3. Aspect of the operating process eg. communication , decision making ,monitoring and controlling mechanisms 4. Do not exist in a vacuum-encompass and are embedded in their environment . 5. Influenced by the environment of the supra system that surrounds it eg. Persons ,groups ,other organization systems that require a response from the organization

Relationship between an organization and its environment

1. Characterized by organizational behavior that is responsive or effective to its environment 2.Environmental responsiveness-change its policies and procedures to accommodate itself to external conditions 3.Modify work place in order to bring in resources &recruit people who can do the job & fulfill its objectives eg. In response to the increased budgetary allocation to the college of nursing and health science we may need to increase the student intake. This will mean recruiting more staffs to cater for the need

Organizational Approaches
Traditional- scientific approach dehumanizing in nature where humans were viewed as economic animals "motivated solely by money reimbursed according to their level of production Human relations-much emphasis put on efficiency and productivity ,motivation and relationships Systems separates activities into small units of tasks & operational units

Organizational structure
Structure-a framework that divides work within an organization and delineates points of authority ,responsibility ,accountability ,and non decision making support

Formal Structure
Organizations have both formal and informal structure . It is a plan or blue print relating people and their tasks to the work environment Helps the organization achieve its objectives Includes pattern of formal relationships & duties designated in the organizational charts ,formal rules ,policies ,procedures, control mechanisms and compensation arrangements Places emphasis on positions in terms of authority &function

Formal Structure
Varies to suit the purpose ,task and work environment More reutilized work ,structure may be a fixed hierarchical model. Complex and varied work like nursing care requires a more open ,flexible structure allowing for open communication and professional autonomy.

Informal structure
Network of social and personal relationships spontaneously created as a result of people working together without the sanction of formal authority . Places emphasis on people and their relationship within the organizational structure.

Types of organizational structures

LINE STRUCTURES Bureaucratic in make up Have a staff component vertical line designating reporting and decision making responsibilities that connects all positions to a centralized authority .

Types of organizational structures

Matrix structures Focuses on product and function Personnel from various functional departments are assigned to a specific program and become responsible to two bosses-their functional department head and a program manager

Types of structures
Flat structure Delegation of decision making to the professionals doing the work Removal of hierarchical layers Authority ,accountability ,autonomy ,responsibility vested upon staff providing care Less formal than hierarchical organizations allowing individualized decisions that fit specific situations and meet current needs

Types of organizational structures

Shared governance or self governanceprofessional practice models-accountability is determined by needs arising from the services provided to clients. Authority ,control ,and autonomy are placed in specifically defined areas of accountability For example, all issues related to nursing practices are dealt with by nursing staff

What determines an organizational structure

Type of work Building and location Financial resources Equipment and supplies Technology Availability of people who are trained to deliver effective ,efficient and economical good and services In the case of a hospital nature of work such as patient care, teaching ,research and prevention it does not allow a fixed structure to be used for all departments

Authority , Responsibility and accountability

Authority the right to act or to command the actions of others based on ones formal position and ones control or sanctions and rewards Comes with position and is not vested in the person Delegation achieving performance of care outcomes for which an individual is accountable and responsible by sharing activities with other individuals who have the appropriate authority to accomplish the work

Accountability
Answerable and liable to the superior for the quality and quantity of the assigned work . Manager answerable for delegating the proper task to the person who can do the job Nurses have traditionally assumed a lot of responsibility but have lacked the delegated authority .

Organizational Chart &communication structure

A diagram of the planned arrangement of people ,various positions &their relationship to each other . Specifies formal authority &communication networks . Two dimensional abstract model of an organizational structure ,usually takes the form of a hierarchical pyramid. It is based on vertical division or scale of duties into levels with functional units according to degrees of authority and responsibility.

Organizational chart &Communication Structure

Decision making &direction are executed from the top ( delegation of authority ).

What determines organizational structure ?

Type of work Building and Location Financial resources Equipment and supplies Technology Availability of people who are trained to deliver effective ,efficient &economical good &services .

What determines organizational structure

In the case of a hospital, nature of work (client care ,teaching ,research and prevention )does not allow a fixed structure to be used for all departments .

Accountability
Authority ,responsibility knowledge and energy flow down from above Accountability and how the was done flow up Title of each position indicates task performed Relative status of a position results from the distance from the top of the chart Lines between positions specify the established pattern for formal interactions and channel of communication

Accountability -continued

Job descriptions clarify positions Can not reflect informal relationships

Delegated authority
Structure determines amount & degree of authority that can be delegated Can be either centralized or decentralized

Centralized a management principle Planning and decision making done by few people at the highest authority hierarchy Directives communicated to workers through formal chain of command

Advantages of decentralization for Nurse

Clinical advantage decision making done by proficient key nurse managers in their roles as clinical specialist or clinical coordinators Increased professional autonomy and personal accountability Nurses can communicate directly with and participate with decision making

Advantages of Decentralization for Nurses -continued

Increased job satisfaction among nurses adaptability to rapid change Establishment of staff position for nurses such as clinical coordinators , in-service matron

Decrease in the operating budget e.g. elimination of unnecessary portfolios

Considerations for planning for a formal structure

The number of work groups The strength of ongoing relationships The combination of necessary skills held in common . The number of personnel needed for staffing The best use of personnel The financial resources

Decentralization
Delegation of authority to workers at operational level who make decisions that affect their work Advantages Overall organizational effectiveness &decision making Delegated authority can equally assume responsibility

Decentralization -continued
Communication can be direct More participative management democratic sharing Decrease of control at the top Increase communication across hierarchical level Increased importance of the individual worker Encouraged to make decisions &solve problems creatively and competently If well controlled goals should be met

Disadvantages of Decentralization to Nurses

Workers at operational level may be inadequately prepared to make good decisions Good interpersonal relationships and complex communication skills may be deficient Increased competition and refusal to cooperate means more control and directives the top management Overall objectives may be ignored or diverted as each unit try to achieve their own goals

Span of control what is it?

The number of people one manager can effectively direct Ratio of subordinates to a manager is not fixed Must reflect the following factors : The level in the organization The nature of the work performed The capacity &skills of the manager The education and skills of the subordinates The time given to outside activities

Informal structure
What happens Interactions &relationships arises spontaneously Relationships cuts across the hierarchical levels and position lines Emphasis is placed on people not positions Not subject to control by the formal structure Consists of small group of members who strongly influence each other

Advantages of Informal structure

Supports values Provide social satisfaction Disperse information Exert control by influencing &regulating the behavior of the group members

Disadvantages of Informal structure

Values supported may mean a resistance change e.g. nurse who abides by the role of a hand maiden to the doctor will find it difficult to change and work at a professional level with the doctor Communication for the benefit of information exchange can degenerate into passing on of unfounded rumors and gossips Group pressures to control behavior may result in conformity

Line staff relationship

What does this mean ? The prevailing emotional state shared by members in the system Must be kept at its best all the times Respect each other and learn to appreciate and consider the other colleagues views Avoid spreading harmful rumors about others Support each other in striving to reach the organizations vision and mission

Group activities and presentations

1 .Draw Bureaucratic organizational charts 2. Discuss advantages and disadvantages of: A-Bureaucratic structures B-Matrix structures C-Flat structures

Presentations

When you have finished doing your activities in allocated groups then you should be ready to present to the whole class

Thank you for your active participation