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Organizational structures, both formal and informal, significantly affect the ways in which employees work, make decisions, and share information with each other. By describing and analyzing the structure of a particular setting, one can understand which of its aspects are beneficial to workers and which problems need to be addressed. The discussed organization is a hospital with a formal structure that possesses characteristics of a bureaucratic and matrix types. The chosen unit, medical non-intensive unit, has a similar framework. The combination of these structures results in centralized decision making, focusing the attention of the staff on the influence of formal leadership, leading to informal leaders feeling undervalued as a result.
Organizational Structure
Both the hospital and the unit operate using the line structure with some modifications. For example, the staff possesses a certain amount of authority due to their field of work (nursing) being an occupation with many responsibilities. However, this system implies that a formal structure of information sharing in enforced at all times, creating a single line of communication between all levels of employees (Marquis & Huston, 2017). For example, nurses must report to their supervisors, who then can deliver the information to the next level of management.
This chain interaction between workers has its benefits and disadvantages. The speed of innovation suffers because new ideas and concerns reach persons with authority slowly, being passed from one member on the chain to another. Thus, the hospital and the unit often fail to implement changes in time, negatively impacting the quality of care as an outcome. To mitigate this problem, the department started to employ some ideal of the matrix structure, allowing nursing leaders to interact with other nurses and present their ideas to the management. According to Wagner et al. (2014), a more horizontal structure contributes to better outcomes for the quality of care, empowering nurses and giving them autonomy. Therefore, the shift to the matrix type is a beneficial decision for the unit.
Leadership and Decision Making
As the organization employs a rather linear structure, most decisions are made in a centralized manner, giving nursing managers more authority than the rest of the staff. The lack of decentralized decision-making practices places more responsibility on managers, increasing their workload. Thus, a small number of people who make important choices feel more pressure than their coworkers. This is a possible drawback of a centralized system along with the slow speed of innovation mentioned above.
Currently, the improved approach where some authority is redistributed to unofficial nursing leaders allows nursing managers to redirect their attention and energy towards essential tasks, leaving some smaller decisions to the staff (van der Voet, 2014). While nurses met this restructuring effort with some protects at first, they quickly realized that their needs are now much more highlighted in all discussions (Spiers, Lo, Hofmeyer, & Cummings, 2016). Both the staff and managers embraced this collaborative method. Informal and formal leaders work together in order to implement innovations into the unit and empower nurses to take on more obligations.
Conclusion
The bureaucratic organizational structure of the discussed hospital was recently improved to include some non-linear channels of communication. This combination of approaches allows nurses to influence the decision-making process and make it less centralized. While the formal leadership still is responsible for the major part of all choices, informal impact provides nurses with a voice and a chance to implement changes based on their personal experiences. In the unit, the collaboration of nurses and managers allows both sides to realize each other’s importance in the organization.
References
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Spiers, J. A., Lo, E., Hofmeyer, A., & Cummings, G. G. (2016). Nurse leaders’ perceptions of influence of organizational restructuring on evidence-informed decision-making. Nursing Leadership, 29(2), 64-81.
van der Voet, J. (2014). The effectiveness and specificity of change management in a public organization: Transformational leadership and a bureaucratic organizational structure. European Management Journal, 32(3), 373-382.
Wagner, C., Mannion, R., Hammer, A., Groene, O., Arah, O. A., Dersarkissian, M.,… DUQuE Project Consortium. (2014). The associations between organizational culture, organizational structure and quality management in European hospitals. International Journal for Quality in Health Care, 26(S1), 74-80.
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