Organisational Structure of Yale-New Haven Hospital - Essay Example

Introduction Organization structure can be defined as the system ii which an organization is organized in terms of management. Formulating an appropriate organizational structure calls for strategic preparation in organizing the structure in relation to the organization’s aspired culture and objectives. Recent studies reveal that the performance of any organization is directly related to how efficient its organizational structure is organized. According to Collins (1998) observers that the structure of an organization affects how work performance in that organization will be. It is important that before an organization undertakes any organizational structure changes, the management of the organization has to agree on what kind of culture and climate they anticipate to create in the organization. The hospital This research paper will take a critical look on YNHH hospital and examine its organization structure, culture and climate. It will review if these three aspects agree with the hospital’s missions, visions and values. Lastly the paper will explore of organization structure, culture and climate affects communication, leadership and nursing care delivery and examines areas of improvements. Yale-New Haven Hospital (YNHH); the hospital has 944 beds and a tertiary referral centre that includes 201 bed sections for children’s hospital, and 76- bed capacity wing Yale NEW Haven Psychiatric hospital. The YNHH also includes the main teaching hospital for Yale university school of medicine (YSM). The hospital boosts of 471 (residents) house staff physicians who ensure around the clock treatment and best care to patients. The hospital has been ranked among the best hospital in American several times. It has also an accreditation from the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). The hospital is ranked second biggest employer in the region with a staff of more than 6000 employees. (YNHH, 2007) Organisational Chart to show the chain of command The Hospital missions The hospital has three main missions that it strives to uphold Patient care; to provide high quality, sensitive affordable health care services to every patient, not withstanding his/her capability to pay. Teaching; Being the main teaching hospital for the Yale University School of Medicine and proffer training chances for nurses and related health care experts Research; Providing a location for continuing medical research which, assists in bringing medical advances from the medical laboratory to the bedside of a patient. (YNHH, 2007) The type of organisational structure of your organisation The hospital has a hierarchical type or organization structure, in which case there are many managers who manage different divisions of the hospital administration. Each manager has a group reporting to him this is done this way because the hospital is too big with a huge number of employees. The hospital similarly has undertaken a lot of activities thus there is a lot of diversity in the in the activities going on. As it can be note there are three hospitals in one thus it calls for a lot of divisions in management for it to be effective. The beauty of this kind of structure is that it easily defined the roles and responsibilities of each worker. It also gives a great opportunity for developing ones professionalism, which is in line which the mission of the hospital. This kind of management structure also gives the employees more opportunities for getting promotions and it has a clear leadership structure. Collins, D. (1998): Difference organisational climate and organisational culture Organization culture According to Schein’s (1992) concept, organizational culture is a model of shared fundamental assumption which an organization has leant in the process of solving its internal integration which has worked adequately well to be taken valid in order to be used to be taught to other new members of the organization. (Schein 1992) organizational culture to schein has three main aspects Artifacts; evident organizational structures and procedures Espoused values; these are goals objective and strategies of the organization Underlying assumptions; unconscious, assumed, thoughts beliefs perceptions and feelings (the eventual source of values and acts) Schein (1992) also points out that we have a deeper essential assumption that has a relationship with views of employees about the organization; that is they influence how employees feel and perceive the organization. Denison (1990) states that; culture of an organization is dynamic and it is a continuous process. Leadership structure o an organization has a major position in defining organizational culture of an organization. Managers and founders of the organization play a significant role in as creators of culture of an organization. Organizational climate According to Denison, D. (1990): organizational climate is the feelings and perceptions employees have concerning the work environment of their organization. There are various aspects which decide the perception of the employees, these aspects includes how the organization treats its workforce, or how the management treats professional ethics or even the social relationship in organization, whether it is warm or cold. The organization climate created can help the organization achieve its goals and objectives or hinder it. Recent research reveals that management structure of an organization plays a significant function in defining the organizational climate in an organization. (Denison, 1990) From the above discussion it is clear that organizational climate has a big role in ensuring that an organization does attain its goals and objectives. YNHH hospital in recognizing this aspect has created a management structure and culture that values employees and rewards their efforts. This has gone a long way in ensuring that the hospital achieves and even surpass its goals. Compared to Health Care Environmental Checklist YNHH hospital strive to excel in its health care services to this end the hospital was awarded a certificate by the (JCAHO). Thus, the hospital has managed to adhere to all stated Health Care Environment checklist requirements. Take for example , the hospital ensures that all patients are discharged on time, the hospital has extensive prevention programs that it carries out in the community, it ensures that patients information is well kept and treated with all the confidentiality required. Encouraging Communication channels Communication is a very important instrument in any organization. It is even more important in the in the healthcare industry. (Quinn, 1988) notes that for an organization to be successful the management structure has to have very effective communication strategies, this relate to employee in the organization. Good organization working environment calls for a high level of effectiveness in the communication. When communication is rightly used in an organization it motivates the employees. However when communication is poor it will always demoralize the workers. Of course this demoralization affects their effectiveness hence leading to losses in the organization. To this end the hospital have create a well structured management system which encourages communication at all levels employees are encourage to communicate any issues that they have to their superiors without fear. (Quinn, 1988) In order for any organization and its management to be effective in its work, the management should have prior knowledge in communication skills. One thing that the management of the hospital recognizes is the workers are human. They have their own feelings and should be treated with humility. The channels of communication are well planned, implemented and also monitored. To improve on communication all managers in the hospital are encouraged to practice the following communication skills; Courteous speech, Direct communication, Feedback, Making time for employees, Listening, Humour and Repetition of values. These communication skills have really improved communication in nursing department of the hospital. (Quinn, 1988) Quinn, (1988) stress the point of communication in an organization by stated that the culture and climate created in organization greatly affects communication in the particularly organization. He further points out that effective communication calls for regular open forums between the management and the employees to freely discuss issues concerning the organization. The management of organizations has to create time in which they can hold staff meetings. The most effective meetings are the ones carried out when each one of the employees is present. However with current big originations that has branches and big departments. Meetings can be held in accordance to the departments or branches for them to be effective, as a large gathering of employee provide sufficient time for any meaningful discussion. To this end the YNHH hospital have several regular meetings in accordance to various levels and departments. Each section in the hospital holds its own meetings and the discussions from the meeting passed to the departments who review what ever was discussed and take the necessary steps. As stated before the hospital has a high regard of its employees, who in turn have a positive feeling about the hospital. Thus, employees’ communication has been highly enhanced. (Quinn, 1988) Encouraging Nursing leadership; Right path in career development Many employees in an organization look for advancement opportunities within the organization. The management needs to work with each of these employees in developing their career advancement plan that puts in to consideration both the employees present skills and future goals and objectives of the employee. If an employee becomes thrilled about his/her prospects at the organization, the employee will definitely become more occupied in his/her current position. The management should assist the employees in improving their professional skills and knowledge by offering on-job training or in-house career advancement. Workshops and seminars should be organized for the employees or they should be allowed to attend workshops and seminars that are related to their profession. Employees should be encouraged to attend adult classes that should be paid by the organization, employees will sense the organization is investing in them, and their will improve their work performance. YNHH strives to achieve this by training its staff regularly, and having organization structure that offers career advancement. Creating teams Teams have been known to improve the performance of an organization and at the same time nurture the leadership skills of team leaders and members as a whole. However, times can only work well if all team members are satisfied with the arrangement of the team. Maund (2001) notes that, effective management structure and culture of an organization affects teams’ performance. At the hospital, the hospital has created several teams in various departments which have a task of achieving their given assignments. For, example there is research teams, emergency teams and even nursing care teams. All these teams give the nurses and other staff opportunity to practice their leadership skills. Teams have a high level of independence. Maund (2001) further explains that, A leader of a team is anticipated to stand apart from the team in relation to his/her position and assist his/her team in explanation of issues, advocate for a team members where justices seems not to be done. A team leader is supposed to clearly understand issues and find their solution. (Maund, 2001) Give opportunity for innovations In line with the hospital mission of being the centre of excellence in research, the management has created a culture being innovative. The hospital encourages its nursing staff and other medical professional to come up with innovative and creative ways and of enhancing health care. This thus develops their skills in leadership has they are given equally opportunities in the hospital. Culture of professionalism and good climate of the hospital also plays an important role in enhancing any leadership abilities the nursing staff may have. (Maund, 2001) Encouraging Nursing care delivery system YNHH hospital is where it is now because of delivering good quality health care to its patients and extensive research and technology that have been embraced by the hospital along the years. An impassive record of YNHH can not be achieved by organization that lacks proper organization structure and strong a culture. Thus some of the aspects that have ensured steady and better nursing care delivery are underlined below. (YNHH, 2007) Creating a positive working environment Promoting an office working atmosphere which makes all employees to feel worthwhile is very important. Managers should not favour any particular employee. The managers also need to keep their doors open so that employees know that they can approach them any time when they have a problem or any question concerning their work. (Maund, 2001) notes that a happy workforce is a productive workforce. To this end, the hospital has put up well organizational structure that encourages its employees to move up the ladder when opportunities arise. The culture of valuing each individual person and giving equally opportunities to the diverse staff without any biasing also has encouraged the workforce in the hospital to give their best and ensure that nursing services given are of high quality. Technology industry has become vital for many organizations, in the recent past technological advancement have assisted many companies and organizations to revolutionize the manner in which they operate and manage their organizations. The world is experiencing fast moving changes in technology development which has led to high competition in many industries. The changes that technology advancement have brought, mainly have increased production and capitulated to cheaper, improved, and more powerful items that have proved to be beneficial to many people. The hospital has been at the fore front in adapting new technologies which has been used to offer better and high quality services to its patients. Today, online booking, online payments and new and modern facilities in the hospital are just some of technology advancement that the hospital has taken. It is surprising on how much these technological aspects have improved the nursing care of the hospital. (Maund, 2001) Safe work environment Employees who feel safe in their work place are inclined to perform better than those who don’t feel safe. A safe environment can be through human-human relationship in the organization or through human to machines. (Cooper, 1998) YNHH hospital has created an organization culture and climate which has made its employees to feel very safe. This has highly improved the performance of the nursing unit which has directly enhanced the delivery of nursing care of the hospital. (Cooper, 1998) Two strategies that could improve or maintain the organisational climate The organizational climate of YNHH remains among the best. However, the management should improve their management structure as hierarchical structure may hamper quick decision making when it comes to emergencies. Being hospital there are many times that the managers in the hospital and administrators are called upon to make a quick medical decision, but because of the management structure is too hierarchical making such decisions may be delayed. Since each manager is assigned a division or department to directly management, there might be certain set of ways of behaviour in certain departments or divisions that are development according to the management style of a particular manage which may not reflect the overall organizational behaviour or culture or the hospital. Thus it is important that though the management structure is effective, it has to be enhanced so that such issues may not arise. The management structure may also hinder the assembling of special medical teams as each hospital is independent of the other in management and the manager of one department may not be willing or cooperative enough to release his subordinate to work in a team proposed. (Moran & Volkwein, 1992) Acknowledging employee efforts Rewarding employees for their good achievements and recognizing their efforts in their specific field will highly improve organization climate of an organization. Hatch, (1993) clearly states that, an organization can make a big difference to an employee’s spirits by merely taking time to distinguish each employee’s accomplishments and contributions, whether small or big. Offering small incentives such as bonus, certificates and other rewards goes a along way in improving the climate of the organization. The hospital management should have a good system of rewarding its employees; the reward should not basically be in monetary form. (Moran & Volkwein, 1992) Conclusion 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. As (Denison, 1990) points out, devising a compatible management structure is the first step in ensuring that the objectives, goals and strategies of the organization will be achieved. Without a robust management structure that will be apt to the size and complexity of an organization and its stated objectives, the stated objectives will not be realized. Communication motivation and proper rewarding structures goes along way in improving the overall performance of an organization. The YNHH has been able to be among best hospitals in America because of having better management structures culture and climate. However, improvements can be always done to improve the climate of the hospital. Reference Collins, D. (1998): Organizational Change: Sociological Perspectives. London: Cooper, D. (1998): Improving Safety Culture. A Practical Guide; Chichester: John Wiley Denison, D. (1990): Corporate Culture and Organizational Effectiveness. New York: Hatch, M.J. (1993): The Dynamics of Organizational Culture. Academy of Management Review, Vol. 18, No. 4, Maund, L. (2001): An Introduction to Human Resource Management: Theory And Practice: Palgrave, Macmillan, Murray, ME & DiCroce, H.R (2003): Leadership and management in nursing, 3rd edition, Prentice Hall, New Jersey. Moran, E.T. & Volkwein, J.F. (1992): The Cultural Approach to the Formation of Organizational Climate; Human Relations, Vol. 25, No. 1, Quinn, R.E. & Rohrbaugh, J. (1983): A Spatial Model of Effectiveness Criteria: Toward a Competing Values Approach to Organizational Analysis. Management Science, Vol.29, No. 3, Quinn, R.E. (1988): Beyond Rational Management. San Francisco: Jossey-Bass. Routledge Schein, E.H. (1992): Organizational Culture and Leadership (2nd edition.). San Francisco; Wiley & Sons Yale-New Haven Hospital (YNHH), (2007) about the hospital: Retrieved from http://www.ynhh.org. Accessed on 20/10/07 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