Nursing Leadership: Organizational Structure

The framework that defines how an organization’s activites are directed to achieve its goals

Organizational Structure

The framework dictates how roles, power, and responsibilities are delegated, controlled, and coordinated

Organizational Structure

3 types of organizational structures

Functional, Division, Matrix

Most common structure where departments are organized by function

Ex: chief nursing officer (CNO) leads all nursing departments (e.g ICU, ER, med-surg). All nurse managers report to the CNO

Functional Structure

This structure states that organization is divided into separate, semi autonomous divisions based on product, service, or patient population.

Division Structure

This structure combines the functional and divisional models. Employees report to 2 managers: functional manager and a project or product manager

Matrix Structure

Decision making authority is concentrated at the top of the organization

Ex: Dean of nursing school dictates all curriculum changes and faculty hiring decisions

Centralization

Consistent Standards, Clear Chain of Command, and efficiency in stable environments but can lead to a lack of staff autonomy

Centralization

Unit Nurse Managers are given autonomy to make staffing and scheduling decisions for their unit

Decentralization

This fosters staff autonomy, and is more flexible and responsive to change but can lead to inconcistency in procedures

Decentralization

defined as system of shared values, beliefs, and assumptions that givern how people behave in an organization. It’s the unwritten rules of the workplace

Organizational Culture

organization’s core purpose and future aspirations

Mission and Vision

fundamental principles that guide behavior (e.g patient centered care, safety

Values

accepted standards of behavior (e.g speaking up about safety concerns are encouraged)

Norms

Tangible representations of the culture (e.g uniforms, awards, the physical environment)

artifacts