Cleveland Clinic Management Structure - Essay Example

Introduction Organizational structure of an organization is highly determined by the kind of the products or services it is engaged in. Equally important is the size of the organization in determining which type of management structure will be well suited for it. Organization structure thus, is the way the organization is organized according to leadership of the organization. Many studies today reveal that, the nature of organization structure has a direct impact on its performance and success. In a nursing organization, good leadership and organization is paramount for nursing organizations to be able to achieve their goals of proving good medical services to patients. For the purpose of this research paper we shall examine Cleveland clinic, one of the biggest and busiest healthcare hospital. Cleveland clinic was established in 1921 as a non profit integrated clinic and a health care facility with research and physician. Today, the clinic serves patients in 14 family health centers and ambulatory surgery centers within the surrounding communities. The clinic has a staff of 1,600 of which 120 are specialties and subspecialties. The clinic is visited by patients from all over the world. Cleveland clinic has a reputation for giving outstanding quality health care, and the U.S news media and the world reports classifies Cleveland clinic among the top three hospitals in America. The clinic has embraced technology and it offers on-line internet –based medicine and other services through its eClevelandclinic website. (Cleveland clinic 2007) Cleveland clinic management structure Source; www.clevelandclinic.org Mission statement The mission of Cleveland clinic is; providing compassionate medical and health care of the best quality in a setup of research and education. (Cleveland clinic 2007) Objectives To achieve the mission of the clinic, several objectives have been formulated, this are; Attracting the most excellent medical, technical and support staff; Doing extremely well in specialized health care sustained by comprehensive education and research. To develop, apply, assess and share new technology; provide effective and affordable health care. And lastly, make sure that quality overrides every decision. (Cleveland clinic 2007) Core values of the clinic, Core values of the clinic are underlined below. Collaboration; the value stress the principle of acting as one unit, the value makes sure that each patient benefits from collective knowledge of the health care professional team. Quality; the clinic is committed to quality that has ensured achievement and innovations at the clinic which has lead to cost effective and excellent patient care. Integrity; adhering to professional and scientific integrity are the moral keystones that determine health care delivery services as well as financial and administration of the clinic. Compassion; being committed to considerate care to the patients includes respecting the patients and their families. The clinic believes in providing the highest standard of services to the patients as well as their families. Commitment; Cleveland clinic being an institution knows its social responsibility to the community within which it exist in and also to the clinic trustees. (Cleveland clinic 2007) The management structure The clinic is headed by chief executive officer; down on the line is the clinic committee which controls and oversees eight major department of the clinic. The organization structure provides a matrix administration/management structure, in that each manager and head of branches are allocated wide portfolio of management. The staff of the hospital is spread sparsely to offer services across the various departments of the clinic and functioning areas. (Charles & Gareth, 2001, pp 102-103) Organization culture Organization culture is the manners in which activities are performed in an organization, the culture of an organization are guided by its values, beliefs, attitudes and experiences of an organization. Organization culture is a defined 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 consists ideas and beliefs about what types of aspirations members should employ to attain these aspirations. Values of an organizations defines 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. (Kotter, 1992, pp 78-80) Research shows that, organization culture and climate of an organization determines the performance of an organization. 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. Kotter (1992, pp 78-80) observers that, culture of an organization is the main motivating force that ensures the success of an organization; culture also determines and represent organizational values. He points out three main aspects of culture which are; Artifacts, Shared values; and Basic assumptions. (Kotter, 1992, pp 78-80) Organization climate How the employees perceive or feel about their organization can be defined as the organization climate. This feelings are not fixed and keep on changing depending on how the organization working environment changes. Employees will have a positive or negative feeling about the changes. The management structure of an organization and how the managers behave and perform their activities have a big impact on the employees feeling about the organization. Similarly, how other employees carry out their duties in the work place also have an impact on how an employee will perceive an organization. Cleveland clinic strives to keep its value to be the work place of choice by creating a working environment that fosters, respect, justice and support. To create organization culture that is strong and climate that is encouraging and enhancing. The clinic organization structure is in line with the health check list as the clinic has put in place all measures, procedures and policies tat adhere to the laid down health check list requirement. (Kotter, 1992, pp 78-80) How organization’s structure, climate and culture affects communication channels Channels of communication Communication is a very important tool in any set up. It is even more important in the business world. For a business organization to be successful, the manager has to use very effective communication strategies. This is in relation to every person in the organization. The business environment calls for a high level of effectiveness in the communication. When communication is rightly used in an organization it can motivate the employees. However when it is wrongly used it will always demoralize the workers. Of course this demoralization affects their effectiveness hence leading to losses in the organization. In the Cleveland clinic, the management has put up measure to ensure and ensure communication such as regular meetings and good and proper communication ethics. Proper organization structure and culture allows free flow of information from the top to the bottom and in a similar way from the bottom to the top. (Handy, 1985, pp 40-43) The clinic has meetings fortnightly for senior managers and holds monthly meeting with its branch managers. These meetings provide support to the organization structure of the clinic. Each department also holds its meetings to follow up these top managements meetings. The meetings are both within the structure, for example clinical unit, and also across the structure, for instance clinical and pediatric departments. The clinic also uses video conferencing most of the time in holding meeting across it international branches, though it reduces costs of traveling and time, it is not as successful as personally meetings. However, these meetings go along way in promoting communication channels among the nurses. (Handy, 1985, pp 40-43) Courtesy is one aspect that has been created in the culture of the clinic; it is a communication culture that is used by managers when communicating to employees. It makes the employees to feel they are valued and they are important. Courteous speech involves the use of words like thank you, welcome, good day among others. These words always go a long way in influencing the employees to be efficient. When the employees do a commendable job, as a manager you need to appreciate what they have done. It will motivate them to do even better. This appreciation can be done in the weekly and also the monthly meetings. There are some managers who even never greet their employees. They feel they are above them so they can’t bend low. Simply ask about their welfare at home and at work. This really makes them to be very efficient hence success in the organization. (Handy, 1985, pp 40-43) How organization’s structure, climate and culture affects Nursing leadership The operational strategy of the clinic and for every department provides a working structure for the year. These working structure are developed during group discussions, thus, there is a chance for each staff to make his/her contribution to the plan. It also gives a chance for the nursing staff to come up with programs and projects that can be used to improve the services of the clinic and to take leadership in implementing them, through assistance from the clinic. Another primary aspect to developed leadership is for employees to view their jobs having similar interests with their career course, so that the workers can be able to fill any competency gaps or experience gaps. To add on that the management has to develop a top-to- down succession program so that key position can be filled by employees in the organization who are qualified for positions arising. When employees know that the organization have their career development at heart, they will be more comfortable working in the organization so to achieve their career development. At the same time the organization will not lose its experienced workforce to rival organizations. The experienced workforce can come up with innovative products or ideas which can be used by the organization to improve its products or service delivery. Cleveland organization structure allows it nursing staff to advance in management when positions arise. This has ensures that their leadership skills and qualities are utilized in the clinic. (Handy, 1985, pp 40-43) It is most definite that new technology, machines, working systems, duty requirements and changes in the job description will require employees to be updated. Need of training in an organization also occurs when it is recommended by the government or by industry training bodies. New innovations and inspirations from the managers in the organization can also necessitate training programs in the organization. The employees can also be trained because of suggestions from professional and other specialist, for instance medical engineers, training officers or work study staff. Training opportunities helps to nature the leadership qualities of talents that are there in the nursing staff. With the clinic creating an enabling and conducive working environment the staffs are encouraged to take initiatives and developed their skills. The clinic offers equally chances, to each nurse without any bias to develop and nature his/her leadership talents. (Handy, 1985, pp 40-43) How organization’s structure, climate and culture affects Nursing care delivery system The clinic has a formal process of measuring performance management; this is a yearly cycle that provides a chance for the clinical staff and the managers to talk about performance and also other work related aspects. Cleveland clinic has also undertaken tracking it nursing staff as in its organization culture and structure to as a measure of enhancing nursing care delivery. Tracking the employee production will enable the management to know where and which are need improvement, those employees who does not perform to the levels of set standards can be told to improve on their abilities or given duties which they can perform best. Since the aim of the clinic is to offer quality services, tracking the employees production will also enable the organization to offer better quality services. The culture of serving the patient first also ensures that nursing care delivery is improved as the staffs strives offer best services to the patients. The clinic also fosters staff relationship through encouraging the nurses to visit other departments, for example by holding meetings in different clinic branches rather than holding the centrally, enhances good working relationship among the clinic workforce which goes a long way in creating a team work spirit and building a better nursing delivery to its patients. The culture that the clinic has created of quality as the most important aspect of the clinic has a positive impact on nursing care delivery of the clinic. Beardwell and Holden ((1997 pp 92-97) states that, employee selection is important as it is a way in which a company ensures that it obtains the right human resource for specific job. Employee sourcing is very important in organization. It consists of administration, performance and staffing. All these are interrelated activities that are carried out in an organization. Management and staffing activities help in ensuring that employees with right or desired skills are recruited. The employees have also to be in the right numbers desired by the organization. Cleveland Management in this case is concerned with ensuring that employees perform their best. Best culture of recruitment processes has ensured that the organization gets the best staff that can improve and add value to the organization and in health care delivery as a whole. (Beardwell & Holden 1997 pp 92-97) Opportunities for improvement Charles & Gareth (2001 pp 102-103) states that, Organization structure of any organization is the most important aspect of the ensuring success of the organization. The clinic needs further enhancement of its matrix structure to engage all the managers in the clinic management and leadership of the clinic. This will necessitate reviewing the meetings and also communication structures to make sure that staffs that are not in the top level management also get an opportunity to give their ideas and contribute in discussion with their colleagues. This will maintain and even improve the current organizational climate in the clinic. (Charles & Gareth, 2001 pp 102-103) Close working relationship between the central management and other departments also will ensure that good working climate is maintained and also allow efficiency and effectiveness in implementation of policies and procedures undertaken by the clinic to enhance and foster a good organizational climate. Providing opportunities for clinic staff to exchange ideas on how to achieve and improve organizational climate will also enhance better organization climate. It should be noted that best things can always be made better. (Charles & Gareth, 2001 pp 102-103) Improving communication Since the clinic strives to improve its organizational climate, it is important that it should develop a more comprehensive communication system. Every area and department of the clinic needs to establish and identify areas in communication it can improve, and how it can be achieved. Establishing a communication portfolio for each of the senior managers would provide the necessary communication improvement needed to take communication agenda to new heights. The clinic also is required to involve clients or patients to make contributions to the communication requirements of the services offered. (Charles & Gareth, 2001 pp 102-103) Conclusion Today, organizations are faced with increasing need to come up with structures that will ensure proper working culture of the organization as well as creating an organization climate that make the employees want to stay in the organization. Employees in an organization are an asset to an organization that needs to be protected and developed. Organizations’ management have a challenge of coming up with organization structure that can add value to the organization and at the same time create a strong culture in the organization. Cleveland hospital has been able to maintain and offer excellent health services by striving to keep its values and objectives of being the best and at the same time having a strong working culture and creating a well enabling working atmosphere for its staff who feel good working in the clinic. Organizations will continue to face challenges on how best they improve their organization structures in order to create a better organization culture and climate. Reference: Beardwell, I. and Holden, L; (1997): Human resource management; a contemporary perspective; London; Financial Times; pp 92-97 Charles W. L. H & Gareth R. J, (2001): Strategic Management. Houghton Mifflin, pp 102-103 Cleveland clinic (2007): about Cleveland clinic; Retrieved from; www.clevelandclinic.org accessed on 10/10/07 Deal T. E. & Kennedy, A. A. (1982): Corporate Cultures: The Rites and Rituals of Corporate Life, Harmondsworth, Penguin Books. Pp 54-56 Handy, C.B. (1985): Understanding Organizations, 3rd Edition, Harmondsworth, Penguin Books, pp 40-43 Kotter, J. (1992): Corporate Culture and Performance, Free Press; pp 78-80 Murray, ME & DiCroce, H.R (2003): Leadership and management in nursing, 3rd edition, Prentice Hall, New Jersey; pp 20-21 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