Health Care: Organizational Structure and Communication

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Introduction

Organizational structure is a framework of allocating tasks and authority and carrying out work procedures in an organization (Kim, 2005, p. 49). Organizational structure determines task allocation, hierarchical relationships, and patterns of interactions.

In other words, it is the system of relationships and rules embodied in an organization (Enayati & Ghasaben, 2012, p. 7174). On the other hand, an effective communication strategy is an important element that any business organization strives to achieve to not only satisfy their customers but also enhance their competitive edge in the market. Effective business communication is also a means of realizing organizational goals and minimizing challenges (Stroh, 2002, p. 55).

The setting of most organizations (particularly large organizations) normally makes it very difficult to achieve effective communication. Kim (2005, p. 50) attributes this to the organizational structure characteristics. As a result, this study will focus on the effect of organizational structural variables on effective communication. The channels of communication created by organizational structure have specific functions in the organization. Therefore, organization structures facilitate or deter an effective flow of communication (Enayati & Ghasaben, 2012, p. 7178).

There are two principal approaches normally used to define the relationship between organizational structure variables and effective communication. The two approaches are the container approach and the social constructionist approach (Eisenberg, Goodall & Trethewey 2007, p. 11). The container approach posits that organizational structure and communication exist separately. The former influences information content and flow.

The information on this approach is transmitted from the channel to the end-user. On the other hand, the social constructionist approach assumes that the existing shape and form of the organization is as a result of communication. According to this approach, the responsibility and power of individuals in an organization are based on the amount of information s/he holds and controls. Communication, in this case, is used to create different variations of social structures, for instance, relationships among employees, teams, and social networks (Eisenberg, Goodall & Trethewey 2007, p. 12).

Our organization has adopted a balancing creativity and constraint approach. In balancing creativity and constraint approach, individuals work within the constraints of the existing organizational structures while embracing change and innovativeness. Whereas the social constructionist approach emphasizes on the use of different languages (for example, teamwork language) to achieve organizational objectives, this approach focuses on achieving an equilibrium between communication that generates desired changes and at the same time responsive to the pre-existing constraints (Stroh, 2002, p. 55).

There are two broad methods of communication used in the organization: formal and informal. The traditional methods of communication have been based on the official route. The formal communication channels are those that are officially approved by the organization and the workers union. Staff appraisal interviews, quality circles, and habitual staff meetings are some of the formal channels used by the organization (Enayati & Ghasaben, 2012, p. 7179).

The formal approach uses all three communication structures namely downward, upward and lateral communication. The approaches used to take into consideration the formal communication channels that can be employed in dual information flow. Effective communication takes place when information moves up and down the hierarchy. As a result, the organization has developed a dual information path which not only inspires employees to spot and solve problems but also helps the organization to remain focused. (Eisenberg, Goodall & Trethewey 2007, p. 11).

Informal channels of communication that are not recognized by the organization and workers union also exist. Informal communication often takes place when workers chat, relay information, and confer personal issues with their trusted colleagues. Therefore, informal communication structures in the organization are mainly opportunistic and spontaneous communication. Informal channels of communication may be deterred or enhance formal communication. One of the merits of using informal channels in the organization is that it transcends hierarchical layers. However, caution must be taken, since formal communication may be altered when information is conveyed via informal channels (Enayati & Ghasaben, 2012, p. 7180).

The organizations communication can also be classified, as internal and external communication. Internal communication encompasses all the channels within the organization (Conrad & Poole, 2002, p. 5). On the other hand, external communication refers to communication between the organization and external stakeholders, including the clients. Examples of external communication include marketing, corporate advertisements, and public relations, among others (Conrad & Poole, 2002, p. 6).

Given that the organization is an inpatient and outpatient rehabilitation center there are internal and external relationships that must be considered. Regarding internal relationships, information complexity and weightiness must be considered. Other factors to be considered include task competition, compliance, and job hierarchy (Conrad & Poole, 2002, p. 6). Complex and weighty information often follows a top-down communication channel. On the other hand, external communication normally considers the targeted number and technicality of the information. The two elements are important, given the fact that external communication targets outsiders (Conrad & Poole, 2002, p. 7).

Ethical Issues

Health care and rehabilitation centers face serious challenges that may affect service delivery. Among these challenges are ethical issues that are increasingly occupying their time and resources (Kashman & Savage, 2003, p. 130). Some of the ethical issues that affect the rehabilitation center include inadequate staff, budget cuts, medical practitioner-patient conflicts, and allocation of limited resources, among others.

There are a few cases where medical practitioners have not used formal ethics to guide them in decision making. Most of the ethical issues facing the managers of the center are related to matters of responsibility, justice, lack of professional autonomy, dishonesty, and mistrust (Kashman & Savage, 2003, p. 131). Most of these ethical issues can be solved legally and financially. However, others can be solved politically or through public relations (Kashman & Savage, 2003, p. 132).

These ethical issues have a considerable impact on the organization, both internally and externally. The current budget cuts mean that the center will not be able to expand long-term care services as earlier proposed. Also, the organization will be unable to hire and train adequate staff needed to run the facility efficiently. Lack of accountability and adherence to work ethics by the employee will pose a major hurdle during the implementation and execution stage (Kashman & Savage, 2003, p. 133).

Conclusion

The setting of most large organizations normally makes it very difficult to achieve effective communication. It is attributed to organizational structure characteristics. There are two principal approaches (container approach and social constructionist approach) normally used to define the relationship between organizational structure variables and effective communication. However, our organization has adopted a balancing creativity and constraint approach, which considers the constraints within the organization while embracing change and innovativeness. Besides, there are two broad methods of communication used in the organization: formal and informal.

These methods are pegged at the complexity and the weightiness of information, task competition, compliance, job hierarchy, and targeted number. Lastly, some of the ethical issues that affect the rehabilitation center include inadequate staff, budget cuts, medical practitioner-patient conflicts, and the allocation of limited resources, among others. These issues heavily affect the proposed plan to expand the facility and hire/train more staff.

References

Conrad, C., & Poole, M. (2002). Strategic Organizational Communication in a Global Economy. Belmont, CA: Wadsworth.

Eisenberg, E. M., Goodall, H. L., & Trethewey, A. (2007). Organizational communication: Balancing creativity and constraint. Boston: Bedford/St. Martins.

Enayati, G., & Ghasaben , M.S. (2012). Studying the effects of organizational culture, organizational structure, and information technology on effectiveness of knowledge management. African Journal of Business Management, 6 (24), 7170-7183.

Kashman, S., & Savage, T.A. (2003). Rehabilitation Healthcare Executives and Ethical Issues. Journal of Top Stroke Rehabilitation, 10 (2), 130-133.

Kim, H.S. (2005). Organizational structure and internal communication as antecedents of employee-organization relationships in the context of organizational justice: a multilevel analysis. Maryland: University of Maryland press.

Stroh, U. (2002). The impact of organizational change approaches to Communication management and relationships with employees: An experimental study. San Francisco, CA : Public Relations Society of America.

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