Class 14: Organizational structure and culture

Organizational structure

The way an orgnaizaiton/group is formed

Who reports to who? Who makes the decisions?

Lines of communication and decision making

Organizational culture

The beliefs, norms and values of an organization

Formal organizational culture

Written statements (missions statement) , job descriptions

Informal organozational culture

Day to day

True representation of the organizations culture/values

Canada health act

Founding principles applied to all residents in Canada (some exceptions)

Execptions to the Canada health act

First Nations and inmates in federal penitentries

CHA principles

Public admin

Comprehensive (covers medically necessary)

Universal

Portablity (same coverage across Canada)

Accessibility (reasonable access, deoends on location)

Non profit vs for profit

Non profit: NLHS

For profit: Pharmacy

Primary healthcare

Broad

Includes primary care and addresses social determinants of health

Primary care

First point of entry into the healthcare system

Primary care provider assesses, diagnosis and treats

Primary health care services are for:

Routine problems and emergencies

Seciondayr health care services

Referall to a specialist, LTC home

Additional/supplementary health care services

Not covered by public health care services

Dental, optical, prescriptions etc

Healthcare external forces

1. Legal (CHA, PHIA)

2. Economic (whats covered and whats not?)

3. Sociocultural (providing care for all cultural backgrounds)

4. Accreditation (formal, independant eval using established standards.)

5. Technology (new dx technology)_

6. Professional associations and unions (CRNNL, RNU, scope of practice and contract)

Mission statement

• A short statement that explains the purpose of the organization.

• Describes who they serve, what they provide, and why they exist.

• It is action-oriented.

Philiosophy

• A statement of the organization's beliefs, principles, and ideals.

• Explains the approach to care or service.

• Reflects how staff should think and act to support the mission.

Centralized organizational design

Decisions are made at the top

Decentralized organizational design

Decisions are made closer to the level of care

Nurse manager makes decisions, needs to have authority to do so

Cons: can be inconsistent between units/manageres

Functional structure

Organizes the organization based on departments (e.g., nursing, finance, HR).All report to one ceo
Pros: clear roles, specialized expertise.
Cons: communication between departments may be limited.

Flat structure

Less formal, empolyees have more input. Decentralized

Few management layers, wide span of control, supports autonomy and teamwork.
Pros: faster decisions, empowers staff.
Cons: managers may be overextended.

Service line structure

More centreed ariund patients and services (manager responsible for each)

Organizes teams around services (e.g., oncology, pediatrics).
Pros: focused care, improves coordination within a service.
Cons: duplication of resources across lines.

Matrix structure

More complex, seperate managers for function and service

Employees report to two leaders (e.g., a functional manager AND a service line manager).
Pros: flexible, supports collaboration.
Cons: can cause conflict or confusion about authority.