The aim of this essay is to critically analyse the organizational structure of Sydney Community Hospital. The essay further aims to enable the vision, mission and strategic objectives. The thesis of this paper is to analyse the traditional organizational structure and implement the modified structure for betterment of services. According to the case study, The Sydney Community Hospital (SCH) is located in the outer northern suburbs of the city with 110-beds. The hospital provides acute surgical, medical, obstetric and emergency services to the people. There is a need to restructure the organizational structure to meet the aggregate demand of wider community. There is a need to develop speciality services in the hospital such as renal services, paediatric, cardiovascular and community services. The case study states that the existing structure is bureaucratic in nature and there is a need to change for better patient outcomes, resource utilization and high quality care. Lastly, the overall strategic goals can be formulated to provide high quality patient-centred care.
As stated in the case study, The Sydney Community Hospital (SCH) follows bureaucratic structure. The case study states that the population has significantly increased in the last fifteen years. The proportion of young families and retirement villages has increased in the city. Functional organizational structure can be defined as the organizational structure in which the organization is divided into small functional departments. The main advantage of functional organizational structure in the healthcare department is that it increases efficiency. The different functional departments help in minimizing the cost of operation and productivity. As the healthcare organization in the case study has different departments such as surgical, medical, obstetric and emergency services, there can be healthy competition among these functions. Further, the bureaucracy in the organization offers a great deal of control over management decisions. There are standardized practices that ensure consistency in The Sydney Community Hospital (Jackson, 2012).
However, there is lack of unity of command in the functional organization structure that leads to ambiguity. The lack of coordination among between different departments results in less mutual relationship. As the different functional departments have spread out working, the administrative cost increases as the cost is minimized with higher efficiency. There is delay in decision making that can adversely impact the healthcare organization. There is no possibility of taking quick decisions as the management has to invest more time to take concrete decisions. As the population is increasing, delay in decision making can lead to business loss and decline in patient care. As the number of diseases and patients falling sick are increasing, the human relations can be spoilt as there is a need for greater number of executives (Zingg et al., 2015).
The strategic goal of the organization is to develop high performing, multidisciplinary teams within the specialist services in order to provide high quality, patient-centred care that is effective, efficient and able to respond to the changing health needs of the population. Considering the limitations as identified above, the alternative organizational structure that shall meet the increasing needs of the population is divisional structure. In the divisional structure, the organization operates as different businesses or profit centres (Foster, Henman, & Denton, 2016). According to the case study, there is a need to develop speciality services in the hospital such as renal services, paediatric, cardiovascular and community services. The mission of the organization is to deliver the highest quality, specialist health care in partnership. The divisional structure can be chosen so that the performance of each division such as paediatric, renal and cardiovascular can be measured directly. Also, the managers of every such division shall be held accountable for the quality of care, customer base, resources utilization and patient outcomes. The divisional structure shall be adopted so that there is greater efficiency among the divisions of the SCH (De Bono, Heling & Borg, 2014).
The vision statement of the hospital is to add to positive health experiences for the community. The divisional structure shall be appropriate for The SCH as it shall help in effective management of acute, surgical, obstetric and surgical procedures. Moreover, it shall also be suitable for the implementation of services such as cardiovascular, renal, trauma, paediatric and cancer related services (Shah et al., 2016). These divisions must be semi-autonomous where there are respective heads to direct, manage and keep the activities under control. The general managers must be appointed so that the different divisions can engage in administrative activities such as promotion, marketing and management (Borkowski, 2013).
The key lines of authority and responsibility for achieving the overall organizational goals is established. For any organization to run effectively there is a need for well-defined command. There must be the board of directors, general manager and the president of chief executive officer. This is important for the central management as it has an integral role to play in the hospital. The central management got an integral role to play in the healthcare organization. The central management must make decisions affecting the entire organization. The issues experienced may be policy-formulation, financing, public relations and taxation. Therefore, there is a need for divisional heads to whom the employees can report (Schmocker et al., 2015). The employees working at lower hierarchical levels shall be accountable to the managers. However, as healthcare organization has situations where the decisions need to be made quickly, the line managers must be given the authority to take decisions for better patient care (Taylor & Van Every, 2013).
In case of divisional structure, there are different divisions that need to be managed by line managers. Therefore, the different divisions of SCH such as paediatric, cancer, obstetric and others can be managed by the line managers. The staffs and nurses working in the different divisions must be accountable to the managers. Also, the employees can provide feedback to the managers so that they know the shortcomings in the hospital. The employees must communicate about the resources required for better patient care and achieving an environment that benefits the overall community. This shall be beneficial as the manager can discharge the duties diligently. This reporting and authority line is different from that of bureaucratic structure. In case of bureaucratic structure, the communication and reporting is one-way. The managers obtained no feedback from the employees that led to improper patient delivery. The employees were accountable to the senior management and not the line managers that made the decision making process lengthy. Therefore, with better reporting in the multidisciplinary teams of divisional structure, the strategic goal of SCH can be obtained (Admi et al., 2015).
Based on the case study, it is analysed that divisional structure shall help in meeting the needs of patients, carers and community. The divisional structure can be adopted by SCH from the bureaucratic structure as it can enhance the performance of each division. The divisional heads can be developed. The results can be assessed individually so that the shortcomings of every division can be tracked. Due to different divisions, there is increased independence. It shall be best suited for the hospital as no division such as cancer or obstetric shall be dependent on one another. The decisions can be made for every department individually. The amount of investment or resource utilization can be made quickly and effectively. Also, as hospital has scope for introduction of new divisions for different body parts such as tooth, ear, bones and others, it shall be easy to expand (Steiger, Hammou, & Galib, 2014).
However, there are a few reasons because of which divisional structure may not be the best strategy. As there are different divisional heads, there is internal competition in the hospital. Therefore, there might be conflict in the hospital. Further, there may be duplicity of functions that are common in all departments such as recruitment, marketing, finance and others. There is a chance that the resources in the hospital may be misused thereby increasing the cost of operations. There may exist selfish attitude while displaying better performance (Ginter, Duncan & Swayne, 2013).
Conclusively, the hospital provides acute surgical, medical, obstetric and emergency services to the people. The proportion of young families and retirement villages has increased in the city. The main advantage of functional organizational structure in the healthcare department is that it increases efficiency. As the different functional departments have spread out working, the administrative cost increases as the cost is minimized with higher efficiency. Also, the managers of every such division shall be held accountable for the quality of care, customer base, resources utilization and patient outcomes. These divisions must be semi-autonomous where there are respective heads to direct, manage and keep the activities under control. For any organization to run effectively there is a need for well-defined command. The employees working at lower hierarchical levels shall be accountable to the managers. The employees can provide feedback to the managers so that they know the shortcomings in the hospital. Also, as hospital has scope for introduction of new divisions for different body parts such as tooth, ear, bones and others, it shall be easy to expand.
References
Admi, H., Muller, E., Ungar, L., Reis, S., Kaffman, M., Naveh, N., & Shadmi, E. (2013). Hospital–community interface: A qualitative study on patients with cancer and health care providers‘ experiences. European Journal of Oncology Nursing, 17(5), 528-535.
Borkowski, N. (2013). Organizational behavior, theory, and design in health care (1st ed.). UK: Jones & Bartlett Publishers.
De Bono, S., Heling, G., & Borg, M. (2014). Organizational culture and its implications for infection prevention and control in healthcare institutions. Journal Of Hospital Infection, 86(1), 1-6. https://dx.doi.org/10.1016/j.jhin.2013.10.007
Foster, M., Henman, P., Gable, A., & Denton, M. (2016). Population health performance as primary healthcare governance in Australia: professionals and the politics of performance. Policy Studies, 37(6), 521-534.
https://dx.doi.org/10.1080/01442872.2015.1118028
Ginter, P., Duncan, W., & Swayne, L. (2013). Strategic management of health care organizations (1st ed.). San Francisco, Calif.: John Wiley & Sons/Jossey-Bass.
Jackson, J. (2012). Organization development (1st ed.). Lanham, MD: University Press of America.
Schmocker, R. K., Holden, S. E., Vang, X., Leverson, G. E., Stafford, L. M. C., & Winslow, E. R. (2015). Association of patient-reported readiness for discharge and hospital consumer assessment of health care providers and systems patient satisfaction scores: a retrospective analysis. Journal of the American College of Surgeons, 221(6), 1073-1082.
Shah, G. H., Luo, H., Winterbauer, N., & Madamala, K. (2016). Addressing psychological, mental health and other behavioural healthcare needs of the underserved populations in the United States: the role of local health departments. Perspectives in public health, 136(2), 86-92.
Steiger, J. S., Hammou, K. A., & Galib, M. H. (2014). An examination of the influence of organizational structure types and management levels on knowledge management practices in organizations. International Journal of Business and Management, 9(6), 43.
Taylor, J., & Van Every, E. (2013). When organization fails: Why authority matters (1st ed.). London: Routledge.
Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., & Clack, L. et al. (2015). Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. The Lancet Infectious Diseases, 15(2), 212-224. https://dx.doi.org/10.1016/s1473-3099(14)70854-0
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