Nursing Management in Miriam Hospital - Essay Example

Introduction Organization structure defines the leadership/ management framework of an organization. With the current heightened competition being witnessed, it is increasingly becoming more important that organizations have a well defined organization structure that can help it in achieve and even surpass its goals. Research shows that organization structure has a direct relation with performance of an organization. As Denison (1990): points out, organization structure and culture of an organization determines how work is performed in that organization. Organization chosen This research paper is going to examine the management structure, culture and climate of Miriam hospital, one of the well known hospitals providing cardiovascular treatment over a long time. Miriam hospital is non-profit private hospital that provides high quality patient care and has outstanding status in the community. The hospital has more than 775 affiliated physicians and around 50 full time house staff. The hospital also has 500 nursing staff and over 1000 health care workers. The hospital is located in providence, Rhode islands. (Miriam hospital, 2007) Miriam’s hospital mission The hospital mission is “inspire one another to improve the health and spirit of lives we touch” (Miriam hospital, 2007) Values; the hospital core values are; Respect; respect is given to each individual with whom the hospital works with. Honesty and fairness; to be sincere and impartial in all the hospital relationships Continuous purist of quality; to constantly strive to attain the best possible quality Honouring; to honour the hospital’s Jewish culture Stewardship of resources; to manage hospital’s financial wealth to improve patient outcome (Miriam hospital, 2007) Vision Miriam hospital has several sated visions that it strive to apply in achieving its mission Safety; targeting all measure to safeguard patient’s lives Excellence; embracing the contribution and value of each person Education and research; advancing health care through quest of new knowledge Spirituality; attending to all aspects of an individual spirit that impact the hospital work Collaboration; to seek collaborations opportunities with other partners (Miriam hospital, 2007) Organizational chart of Miriam hospital Literature on organization structure of Miriam hospital Organizational structure shows the way leadership in organization flows, from the top to the bottom. Structure of an organization is mostly determined by the size, type and management style of the organization. In Miriam hospital, the organizational structure is founded on divisional management structure. This kind of organization structure allows the organization to be divided in small management units depending on their functions which operates with some autonomy. This kind of organization structure allows the hospital to run its departments more effectively as it is easy to management smaller units separately than the whole organization at ago. (Mason, 1984) Differences between organizational climate and organizational culture Organization culture and climate are closely related, however many scholars argue that organization climate is defined by organization culture. Both culture and climate of an organization have a relationship on the organization process, which includes behaviour attitudes and service delivery of the organization. (Parker, 2000) Organizational culture Parker (2000) explains organization organizational culture as specific set of norms and values those employees and other groups share in an organization, which determines the way they interrelate with each other and with organization’s management. Organization values are beliefs and notions about the kind of aspirations employees should use to achieve these aspirations. Organization values defines the customs of an organization, expectations of the organization and guidelines that lay down suitable kinds of conduct by employees in specific circumstances and organize the relation of employees in the organization. Mason (1984) also defines organizational culture as “the values, beliefs and norms expressed in actual practices and behaviours of the organization’s members.” Organization’s culture is very important to the organization has it will determine the success or the failure of an organization. As Parker (2000) clearly states, culture of an organization is the primary motivating factor that ensures success of an organization. To Parker (2000) culture of an organization goes along way to determine how effective and efficient an organization will be in terms of its performance. Thus organizational culture highly affects how work is performed in an organization Organization climate How employees feels and perceives their organization is defined as organization climate. This feelings and perceptions are normally determined by the organizational structure and culture. It is important to note the employees’ feelings can be changed within a certain period either in days or hours, thus organization climate is very dynamic. Employees get these feelings from observing what is done in the organization by the management and how it is done. Also other fellow employees directly or indirectly affect the perceptions of employees. (Parker, 2000) Miriam hospital being one of the top hospitals has created a good organizational climate in accordance to its values of respect and quality service. The working atmosphere created in the hospital is encouraging and employees have positive feelings about the hospital (Miriam hospital, 2007) Compared to Health Care Environmental Checklist The hospital has managed to adhere to the health care environmental check list. For example, the hospital has prevention programs that it carries out to community, has opportunities for training and has home care health services. In summary the hospital keeps stated health care environmental requirements How organization’s structure, climate and culture encourages the development of the following: Communication channels It has been observed that many communication short comings in many organizations result from poor structural planning of the employees by the management, such problems may be for example, late issuing of job descriptions and contracts, lack of timely and adequate introductions of new employees to the organizations, delays in responding to issues raised meeting and confusion about the level of power in the organization structure. To address this issue, Miriam hospital has cultivated a culture of free and effective communication by encouraging the management and the staff to work as a family and talk freely. Employees and management are encouraged to have informally communication wherever possible to enhance good and effective communication. (Saul, 1990) The organization structure is known to affect communication channels of an organization very much. Organizational structure determined how effective and fast communication can travel in the organization especially where a command is being issued. The term “organization communication” is normally applied by organizations to mean the process that is used to facilitate the exchange of information and knowledge of the organization with its internal and external publics or individuals that have a direct relationship with the organization. Organization communication is usually used within the organization’s internal communication by the managements as share information with the employees’ investors, customers and the organization partners. Such sharing of information builds communication channels and enhances it. To this the Miriam hospital shares information freely with its employees patients and partners which a build a culture of openness that highly assist in enhancing communication for all organization employees including the nursing staff. (Saul, 1990) Miriam hospital has fashioned a professionalism culture and a good working climate which has brought about good feeling among its workforce, thus creating effective communication channels. The hospital puts emphasis on sharing of information, ideas and experience among its employees and patients both internally and externally. The internal communication is to relate and enhance the employees in the hospital. The external communication is used to inform the outside world what the hospital is doing. the main objectives of this communications are to inform employees what other stakeholders of what is going on in the hospital, promote policy changes, raise fund for the hospital and to monitor the progress of the strategic plans of the hospital and revise them where need be. As it can be observed the hospital has put a lot on communication as it realizes that good communication ensure that no frictions occur and improves the performance of its workforce. Thus the hospital has created a good culture and climate that enhances communication in the hospital. (Saul, 1990) Nursing leadership Developing leadership in an organization is important as it enables good continuity when it comes to changing leadership in the organization. Reason (1993) says that, developing leadership should be a priority for an organization. He further states that, employees need to view their jobs as having similar interests with their carrier course so that they can concentrate on gaining the required qualifications to advance, whether it is experience or leadership skills. The management needs 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. This will ensure that the organization will not lose its experienced employees to rival organizations. The experienced employees can come up with innovative products or ideas that can be applied by the organization to improve its products or service delivery. Miriam hospital has a clear management structure that gives opportunities to its employees and allows them to advance in their leadership. (Reason, 1993) Miriam hospital through its value of being a leader in research and innovation creates and encourages the all medical staff especially the nurses working in this hospital to take leadership initiative through research and innovations that they can develop. Leadership also need to nurtured and developed in order for it to grow. This can only occur in an environment that is enabling and encouraging. To this develop its medical staff, Miriam hospital hold workshops and seminars to develop leadership skills of its staff. The hospital culture of professionalism also highly enhances leadership skills of its employees. (Reason, 1993) Organization structure and culture ploys an important role in nurturing leadership qualities of employees in an organization. Leadership involves motivating employees towards attaining the goals and objectives of an organization. Employees can be influenced through incentives, discipline and team work. The primary objective of motivating the employees is to ensure that they channel all their attention towards the achievement of organization goals and objectives. Thus, motivation is important in developing leadership in an organization. A well motivated employee will give his best, this can only happen in a culture that encourages employees to develop their skills and a climate that enhances it. At Miriam hospital both this aspects are present and many nurses have enhanced and developed their leadership skills at the hospital. (Reason, 1993) Nursing care delivery system In order to any organization to improve its service delivery it has to put standards on how the service should be performed and also monitor those standards to see where improvement is needed. Gagliardi (1986) clearly observes that, measuring performance and tracking employees’ performance is important in ensuring that good services are provided. Tracking an employee performance enables the management to identify where improvements are needed and how the improvements can be improved. If an employee is not performing to the required standards then the best thing is to relocate him/her other duties. Studies show that giving an employee the right duties that he can perform without difficult makes him/her more productive and eager to try other difficult assignments. Miriam hospital in its efforts to improve nursing delivery has created a structure that tracks the performance of its nursing staff. Also, since the hospital aims at providing quality health services it has created a culture that stresses professionalism and better service to its patients. (Gagliardi, 1986) Good communication remains an important aspect in ensuring that an organization achieve it goals. At the same moment good communication affects performance service delivery of an organization. Good communication structure developed at the Miriam hospital ensured effective communication which in turn has enhanced nursing care delivery of the hospital. The hospital ensures that there is timely and prompt response to any health complaints brought forward, especially by the patients. The hospital culture of respecting each other also has ensured that employees value and respect each other, thus, ensuring good service delivery from the hospital. good communication culture a climate allows the nursing staff to air their views on areas that they feel that should b improved to the management and thus when implemented goes a long way in enhancing the nursing care delivery system of the hospital. (Gagliardi, 1986) As stated earlier, organization structure, culture and climate directly impacts the performance of an organization. A well defined management structure and strong culture will ensure that objectives of an organization are objectives and goals. To this end the Miriam hospital has a well management structure that has a well defined management functions within the hospital. The hospital system runs smoothly and all employees know whom to report to and perform their duties well. This has improved the nursing care delivery of Miriam hospital. (Gagliardi, 1986) Areas of improvement Offering latest training to employees Each organization has an area it can improve, no matter how good the organization is; there is always room for employment. Mason (1984) notes that the best way of improving an organization is through improving its staff. Thus, Miriam hospital needs to come up with more extensive programs to improve its workforce. The most important strategy is to over continuous training of its employees. With constant new technologies, drugs and services being witnessed in the medical industry, it is vital that the hospital improves its training and so that it’s nursing and other medical staff is not left behind. Improving organizational culture Parker (2000) states that, Organization structure and culture of any organization is the most important aspect of the ensuring success of the organization. An Organization culture should be all to incorporate all diverse cultures that employees come with as each employee comes from a different background and brings to an organization different cultural background. However, if an organization does not have a universal culture it bound not be attractive to some employees. In relation to that the Miriam hospital needs to develop a more universal culture as currently it has a very strong Jewish culture as it was founded mostly by Jewish members. Since the hospital now attracts staff from different countries, it is important that they incorporate other cultures and ensure that it is more universal, this will greatly improve the climate and culture of the hospital. The results will be better service delivery. (Parker, 2000) Conclusion Organization structure, culture and climate determine the way things are done in the organization and how the workers feel about the organization. A strong organization culture insures that the organization performance is achieved. However, poor organizational structures and culture is the main cause why many organizations collapse. Research shows that over 80% of organizations collapse because of poor organizational structure. Communication, leadership and service delivery are some of the aspects that are affected by organization structure and culture. Miriam hospital has remained one of the best hospitals because of its good organizational structure and climate. However, organizations will continue to face challenges in formulating better organizational structure to overcome increasing challenges that come up every day. Reference: Denison, D. (1990): Corporate Culture and Organizational Effectiveness. New York: John Wiley, Gagliardi, P. (1986): The Creation and Change of Organizational Cultures: A Conceptual Framework; Organization Studies Mason, D. (1984): Voluntary Non Profit Enterprise Management, New York: Plenum Press, Miriam hospital (2007) about Miriam hospital; Retrieved from; www.lifespan.org/tmh Accessed on 21/10/07 Murray, ME & DiCroce, H.R (2003): Leadership and management in nursing, 3rd edition, Prentice Hall, New Jersey; pp 20-21 Parker, M. (2000): Organizational Culture and Identity. London: Sage. Reason, J. (1993): Managing the Management Risk: New Approaches to Organizational Safety; Hove: Lawrence Erlbaum. Saul. G (1990): In Organizations, As in Architecture, Form Follows Functions." Organizational Dynamics, 19; American Management Association, 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