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Nur 492 - Organizational Structure and Culture

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Organizational Structure and Cultural Paper

University Of Phoenix

Senior Practicum: Leadership and Management


Linda Martorano

June 20, 2011

Organizational Structure and Cultural Paper

The purpose of this paper is to discuss the organizational structure and culture of the facility where I am currently employed. In this paper the subject to discuss is how the structure of the hospital creates an environment of support for client centered care. In this paper the topics of information systems, communication methods, and decision- making ability with culture and organizational structure of the agency will be discussed. Also included is how communication and reporting is accomplished in an informal and formal way. The issues of power and control as well as leaders in the organization will be addressed. The social and cultural influences of the community and integration into the delivery system will be discussed. Last, the generational differences that influence the organizational culture of the work environment will be incorporated into the paper.

I am currently employed at St Rose Dominican Hospital which is an acute care facility that functions under the classical theory. The classical theory consists of organizational design that subdivides work and specifying tasks. The classical theory allows the different departments to run with efficiency by giving staff members different task to perform. The classical theory is composed of four elements: division and specialization of labor, chain of command, organizational structure, and span of command. Division and specialization of labor reduces the workload of the employee that will increase proficiency throughout the organization. The chain is how many employees a manager can effectively manage. (Sullivan & Decker, 2002).

The structure of this organization provides for an environment for client centered care by offering services of acute care with different levels of care such as emergency services, med-surgical units, intermediate care unit, intensive care and labor and delivery. Each division is managed by a specific leader, such as the manager, who reports to the chief of nursing. The managers are more in contact with staff and have direct communication with staff members as well as patients in the hospital. This personal level of communication allows for managers effectively to communicate the importance of the mission of the hospital, which is to exceed expectations and provide quality health care to all at all times. With this mission in mind, it can lead to a close relationship with client care.

The use of information systems is the way to communicate throughout the hospital to staff members. There are two charting systems used in the organization and an assignment board system in each department. The first one is Firstnet, which is used in the emergency department, and the second is the Powerchart used in the other departments in the hospital. All information systems are visible to all nursing staff but cannot be edited interdepartmentally. Verbal communication method can be in the form of informing peers concerning the level of care already delivered to a patient and expecting others to follow through. We are expected to formally inform each other of what need to be done concerning our patient via the Firstnet and Powerchart. The Microsoft Outlook us by staff for internal communication and exchange purposes, and it can be accessed both in the hospital and at home via the CHW main site. Information from different departments comes to staff via e-mail, and all are encouraged to check their email daily. Staff members are also provided with a physical mail box, with their names on it where everyone is provided with departmental information. Decision making regarding policy change may be done by departmental basis, but must be approved by the chief nursing executive. For example, the standard of work was change in the triage process, but before management implemented the change, it had to be approved by the chief nurse executive, and he



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