Organizational Structure and Nursing Leadership - Essay Example

Introduction Setting up a suitable organizational structure requires a strategic planning and objective of the specific organization by taking into consideration the aspired organization culture, determining on proper organization structure and recognizing the crucial activity areas in the organization. This is a vital fist step in developing organization structure and leadership. Campbell, et al (1970) clearly states that, before undertaking any changes, the management must agree on a structure which can be able to support organization’s strategic direction being undertaken and organization culture and climate they target to create. This applies to each organization and nursing organization also needs to undertake the same procedures. The hospital This research paper on organization structure and leadership in relation to nursing will take a critical look at Stanford hospital. Stanford hospital is world renowned hospital for its advanced patient care that is provided by its medical staff, specifically for treatment of complex and rare disorders in such areas as, cancer treatment cardiac care and organ transplants. The hospital has a total medical staff that numbers 1,910, out of this house staff are 850 and 1471 are registered nurses. The hospital provides both general severe care services and also tertiary health care for patients from within, nationally and also internationally. (Stanford hospital, 2007) The mission of the hospital In order for the patients and the whole community to benefit, the hospital set up this mission; To care To educate To discover (Stanford hospital, 2007) Values and aspirations The hospital has five core values that it follows and which it expects others to follow, this core values are; Respect; considering and appreciating each person Honesty; being sincere and truthful in everything the hospital does Compassion; caring and showing kindness to everyone Teamwork; working together with a spirit of active participation, cooperation and individual inventiveness. Excellence; committed to giving the best at all the times. (Stanford hospital, 2007) The type of organizational structure of Stanford hospital To Campbell, et al (1970) Organization structure is a way of representing relations in an organization; it shows how groups are interrelated in organization. In many cases organization structure is depicted in an organizational structure chart. Organization structure of an organization show the current management, communication channels of the organization and how they are coordinated. The vision of an organization can be displayed in the organization structure. Stanford hospital management structure is a divisional type of structure which allows the hospital to be management to be divided in to department that manages their own activities through formulation their own objectives and goals. This creates internal accountability and competitiveness. The hospital organization structure is shown below. Organization structure of Stanford hospital Differences between organizational climate and organizational culture Studies suggest that Organization culture and climate have a direct impact towards the performance of the organization. Culture and climate of the organization are related to the process of the organization, client outcomes, service quality and employee’s attitudes behaviors and perceptions. (Guion, 1973) Culture of an organization Culture of the organization is defined through the organizations norms, values and schemas. Organization culture encompasses customs and expectations in relation to how employees behave and how work is done in an organization. (Guion, 1973) A strong culture promotes interactions among employees and assists employees to attain high satisfaction. A good organization culture should not threaten individual security. Culture of an organization is natured for a long and is normally unique in accordance to that organization. Some organization fosters strong culture in terms of quality while others can stress customer care. Those organizations that are customer oriented tend to have a culture that highly values its clients and customers. (Guion, 1973) At Stanford hospital, the hospital has developed a strong working culture among its workforce. As it stated in the hospital’ values the hospital strives to be a centre of excellence, where respect and honesty and team work is encouraged. Climate of an organization James & Jones (1974) defines organizational climate as how employees perceive the social and the work environment of the organization. Several aspects determine this perception, such as how the social relations in organization are they warm and caring? Or they are cold and uncaring. Other aspect includes how the management treats its employees, is it fair, and are employees being recognized? And how do employees take the aspect of excellence. Management of an organization can familiarize and motivate employees to do things the right way and be innovative also. The climate created by the organization can either undermine or promote organization culture or behavior which supports the organization’s strategic objectives in relation to innovation. Studies show that management plays important role in defining the climate of an organization. (James & Jones, 1974) As noted above organization climate has a direct impact in ensuring that an organization achieve its goals objectives and targets. Stanford hospital has created just ways of dealing with its employing by rewarding and recognizing their efforts. This has been achieved through better financial incentives and good working conditions. All this have contributed to the positive feelings of its employees about the hospital and work hard to achieve the stated hospital objectives of providing excellence medical services to all and being a leader in health services. To this the hospital has achieved it as it is among the best hospital in America according to media reports. Compared to Health Care Environmental Checklist In looking at the health care environmental check list, it is apparent that the hospital has managed to adhere to outlined requirements in the check list. For instance the hospital has prevention programs that it offers to the public, ensures that patients’ records are well kept and discharges its patients on time. In addition the hospital has home care services and offers ambulatory/ out patient services. Equally important is that an opportunity exists for advanced practice nurses. In general the hospital has achieved all stated health environmental care check list. Effects of organization’s structure, climate/ culture on communication channels It has been stated that organization structure, climate and culture highly affects the communications channels of an organization. Well structured organization structure allows easy flow of information which in turn allows a quick response from the concerned party. The hospital has created a culture of openness and respect which has created a good climate that allows the hospital staff to air their views without fear. Respect has ensured that managers and employees values and different views from the diverse staff that works in the hospital. Thus, the organizations structure and culture have enhanced communication channels in the hospital. (Campbell, et al 1970) Also to have good communication in an organization, channels of communication have to be planned, implemented and also monitored. At Stanford hospital, the organization structure and culture has ensured that regular review of communications channels is undertaken to make correction or improvement where necessary. (Campbell, et al 1970) Listening is an important aspect of communication, without creating time to listen, it becomes hard to communicate and know where the problem is. This is one of the management cultures that have been emphasized at the hospital. For the organization to have efficient service delivery, the managers have learnt the communication skill of simply listening. The managers have learnt to listen to what the employees are saying. The management has ensured that there are open forums with the employees. This is where the employees speak out on any issues affecting them to the managers. Employees always have so many issues that are affecting them. They can be matters concerning their profession or even their safety at work. When the management listens to such issues, they will always feel that the management is concerned and they care about them. This makes them to be very efficient when at work. Some employees have family issues that affect their working. Unless the management listens and take action, they may never address these issues. If they listen they can even provide guiding and counseling to the employees. There are sometimes some matters that need to be dealt with urgency. When the management is of good listener then the issues can be dealt with before they go overboard. Research shows that, communication is highly enhanced by listening. This usually has a positive effect on employees they well fell appreciated and valued and be eager to communicate issues (Campbell, et al 1970) Effects of organization’s structure, climate/ culture affects on 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’ behavior towards the attainment of the organizations’ goals. To this end Stanford hospital have developed a structure that allows managers and their juniors to share leadership. Tin the world of medicine where innovation take centre place the hospital encourages all employees to take initiative in their own fields. The hospital also through its culture of teamwork has ensured tat its staff express their leadership abilities by forming self regulating teams. As observed earlier encouraging climate ensures that employees perform to their best level including nurturing their leadership talents; employees at the hospital have a very positive feeling about their organization. In case of team leadership, 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 Leadership behavior in work include; directive, supportive, participate and achievement oriented. They are concerned with people feelings and making things pleasant for the followers and defining tasks requirements and other aspects of the work agenda. Campbell, et al (1970) observers that type of leadership adopted will highly influence the relationship between the leader and the followers who are employees. Stanford hospital leadership is supportive and allows participation. Effects of organization’s structure, climate and culture affects on nursing care delivery system The employees of the organization are the most important asset of that organization, and depending on their perception of the organization, they will determine how effective and efficient the service delivery of that organization will be. Thus, proper organization structure that have a well defined management structure and the right staff in terms of numbers and qualification will assure an organization of effective service delivery. At this end the hospital has ensured that staffing and training are highly carried out. In human development, new ways of working are sought and passed on to the employees, so the managers have to accelerate change in an organization. The workers are not just treated as collective workforce, but as individuals. The hospital culture of teamwork which encourages employees and the management to work with a spirit of cooperation goes along way in improving nursing service delivery. Employees are taught to have a good view of the management-like business partners and not as separate entities. (Bonoma & Zaltman, 1981) A customer being the most important person, customer satisfaction is very important for any serious service provider. Hence, Stanford hospital puts the satisfaction of a customer in this a patient first. The hospital has developed culture of “going all the way to satisfy a patient” this incorporates having policies and objectives that are customer oriented. It also involves creating a culture and a climate that values puts the customer first. As Bonoma & Zaltman, (1981) points out customer satisfaction involves providing services to the customer before buying, during buying and after making the purchase. Thus, the hospital has put up sequence of activities that are designed to improve the standard of satisfaction. The importance of customer service varies in accordance to product, the industry and the customer for example; a patient may need advice before medical care service. In such a case the advice is more important to the patient than the real medical care service. (Bonoma & Zaltman, 1981) Normally, employees in an organization bring with them patterns of thinking networks or thinking attitudes. Habits and social pleasures which people have learnt within their communities are also brought into the organization. This will result in re-structuring of organization to effectively determine the culture that should be adopted by all people in the organization with a view to creating harmony among all the employees. Proper management of diversity within the organization is suitable for allowing the diverse people in the organization who share varied experiences or background to effectively combine forces and boost the organization’s productivity. Stanford hospital has responded well to this diversity by creating a culture that is universal which has ensured that delivery of nursing services in excellent. (Bonoma & Zaltman, 1981) Improving the hospital organizational climate The hospital can implement “management structure performance” To achieve more and create a more effective organization climate that will be able to achieve the goals and objectives of the hospital, the management can arrange frequent reviews of how effective the management structure is analyzing the suitability of each management structure against suggested newer objectives and strategies thereby making evaluations of the hospital management structures against the existing organizational structure and climate. This will enable the hospital to make individual changes to constituents and or to the whole structure. The hospital should carry out a major review annual as a major part of reviewing and adjusting set annual objectives and strategies. At these annual reviews small and major changes can be agreed upon to adjust the management structure to match the new requirement proposed by revived operational and strategic objectives. To add on that the organization climate ought to be an agenda point on at quarterly administrative level meetings, here, corrective actions can be determined on where needed. (House & Rizzo, 1972) The hospital can implement employee recognition The employee recognition, which is basically an instrument that strengthens and compensates the most significant production that the employees have created for the organization is regarded as another improving organizational climate. The hospital should have an employee recognition structure that is made simple, instant, and effectively supportive to the employees and the organization at large. Under this, the management team can ensure that a principle for performance is established, involving the rewardable behavior of the employees, thus all of them should be entitled to the recognition by the hospital. This recognition structure should normally supply the employees with specific information about the behavior they are being rewarded for. The hospital’s management team should states that, any employee who performs at a specified level will receive a reward. Basically recognition occurs hand in hand with performance of the employees, thus it reinforces the employees’ encouragement. This will highly improve if not maintaining the current organizational climate. (House & Rizzo, 1972) Conclusion Formulating 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. As Guion (1973) notes, culture and climate created in an organization are the driving force in employees achieving the organization objectives. Strong organization culture creates a warm and conducive working climate that makes employees to have a positive perception of their organizations. Stanford hospital has been able to reach where it is by formulating a good organization structure that reflects the hospital objectives of providing the best medical services. The hospital culture and climate also have highly enhanced communication, leadership and service delivery of the hospital. Reference Bonoma, T, & Zaltman, G (1981): Psychology for Management. Boston: Kent Campbell, J, et al (1970): Managerial behavior; Performance and effectiveness New York: McGraw-Hill. Guion, R. (1973): A note on organizational climate; Organizational Behavior and Human Performance. House R & Rizzo, J (1972). Toward the measure of organizational practices: Scale development and validation; Journal of Applied Psychology. Jackosky, E & Slocum, J (1988): A longitudinal study of climates; Journal of Organizational Behavior. 9, James, L, & Jones, A (1974); Organizational Climate: A review of theory and research. Psychological Bulletin, 12, Murray, ME & DiCroce, H.R (2003): Leadership and management in nursing, 3rd edition, Prentice Hall, New Jersey; pp 20-21 Stanford hospital (2007): About us: Retrieved from: www.stanfordhospital.com accessed on 11/10/07 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. Read More